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COPD TX by PFT Evaluation (All Stages (Disease management education,…
COPD TX by PFT Evaluation
Stage IV: Very Severe
Diagnostic/Prognostic Criteria
FEV1/FVC < 70%
FEV1 < 30% predicted OR
FEV1 < 50% predicted + chronic respiratory failure
Treatment
Add long-term 02 therapy if justified
Consider lung volume reduction surgery (emphysema only)
Stage II: Moderate
Diagnostic/Prognostic Criteria
FEV1/FVC < 70%
FEV1 = 50-79% predicted
SOB on exertion
Treatment
Regular use of LABA
Consider combined LABA + Long-acting anticholinergic
Stage I: Mild
Diagnostic/Prognostic Criteria
FEV1/FVC < 70%
FEV1 greater than or equal to 80% predicted
Treatment
SABA or inhaled anticholinergic (tiotropium) PRN
Stage III: Severe
Diagnostic/Prognostic Criteria
FEV1/FVC < 70%
FEV1 = 30-49% predicted
SOB on exertion
Frequent exacerbations
Treatment
Add inhaled steroids if frequent exacerbations
Consider combining steroid + LABA (fluticasone + salmeterol)
All Stages
Disease management education
Smoking cessasion
Pulmonary rehabilitation
Influenza and Pneumococcal vaccination