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COPD - Coggle Diagram
COPD
Pathophysiology
Gastrapping
Abnormal gas exchange
Mucus hypersecretion
Pulmonary hypertension
Exacerbations
80% Viral
influenza
Rhinovirus
parainfluenza
Bacterial
Haemophilus
Moraxella
Streptococcus pnumonia
Definition
Small airway inflammation
Bronchiolitis
Parenchymal destruction
Emphysema
Post bronchodilator
FEV1/FVC ratio <0.7
Management
Admission
T1RF despite oxygen/ T2RF despite NIV
Intubation
Respiratory arrest
Respiratory distress
Contraindications to NIV
Vasopressors/inotropes
Mental state deterioration
Poorly responsive to medical management
Medical Management
Bronchodilators
Steriods
Aminophylline
Antibiotics
Doxapram
If NIV unavilable
NIV/ventilation
Limit Intrinsic PEEP
<venous return
PVR
Barotrauma
DIABOLO trial
No improvement with acetazolamide
Markers of poor survival
Ventilation >72 hours
Previous mechanical ventilation
Classification
MRC dyspnoea scale
Grade 1 = strenuous exercise
Grade 2 = walking up hill
Grade 3 = 15 min of walking
Grade 4 = 100 yeards
Grade 5 = dressing
GOLD
Mild = FEV1 >80%
MOderate = 50-79%
Severe = 30-49%
Very Severe = <30%