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Last reviewed: 11 Dec 2025
Last updated: 13 May 2025

Summary

Definition

History and exam

Key diagnostic factors

  • cough
  • shortness of breath
  • sputum production
  • exposure to risk factors

Other diagnostic factors

  • barrel chest
  • hyperresonance on percussion
  • distant breath sounds on auscultation
  • poor air movement on auscultation
  • wheezing on auscultation
  • coarse crackles
  • tachypnea
  • asterixis
  • distended neck veins
  • lower-extremity swelling
  • fatigue
  • weight loss
  • muscle loss
  • headache
  • pursed lip breathing
  • cyanosis
  • loud P2
  • hepatojugular reflux
  • hepatosplenomegaly
  • clubbing

Risk factors

  • cigarette smoking
  • advanced age
  • genetic factors
  • lung growth and development
  • white ancestry
  • exposure to air pollution
  • exposure to burning solid or biomass fuel
  • occupational exposure to dusts, chemicals, pesticides, vapors, fumes, or gases
  • male sex
  • low socioeconomic status
  • rheumatoid arthritis

诊断性检查

首要检查

  • spirometry
  • standardized symptoms score
  • pulse oximetry
  • ABG
  • Chest x-ray
  • CBC

需考虑的检查

  • pulmonary function tests
  • chest CT scan
  • serial peak flow measurement
  • sputum culture
  • alpha-1 antitrypsin level
  • exercise testing
  • sleep study
  • respiratory muscle function
  • ECG
  • echocardiogram
  • blood eosinophil count

治疗流程

撰稿人

作者

Manoochehr Abadian Sharifabad, MD
Manoochehr Abadian Sharifabad

Fountain Valley Regional Medical Center

Fountain Valley

CA

利益声明

MAS declares that he has no competing interests.

鸣谢

Dr Manoochehr Abadian Sharifabad would like to gratefully acknowledge Dr Jonathan P. Parsons and Dr Michael Ezzie, the previous contributors to this topic.

利益声明

JPP has contributed at speakers' bureaus for GlaxoSmithKline, Inc., Schering-Plough, Inc., and AstraZeneca, Inc. ME declares that he has no competing interests.

同行评议者

Hormoz Ashtyani, MD, FCCP

Hackensack University Medical Center

Hackensack

NJ

利益声明

HA declares that he has no competing interests.

Alejandro Comellas, MD

Clinical Professor of Internal Medicine-Pulmonary, Critical Care and Occupational Medicine

University of Iowa

Iowa City

IA

利益声明

AC has received payments as a consultant for GSK and AstraZeneca. He also serves as a nonpaid consultant for VIDA.

William Janssen, MD

Assistant Professor of Medicine

National Jewish Medical and Research Center

University of Colorado Health Sciences Center

Denver

CO

利益声明

WJ declares that he has no competing interests.

Francis Thien, MD, FRACP, FCCP

Associate Professor

Director of Respiratory Medicine

Eastern Health & Monash University

Victoria

Australia

Declarações

FT declares that he has no competing interests.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Referências

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Principais artigos

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2025 report. 2025 [internet publication].Texto completo

National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. Jul 2019 [internet publication].Texto completo

Nici L, Mammen MJ, Charbek E, et al. Pharmacologic management of chronic obstructive pulmonary disease. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020 May 1;201(9):e56-69.Texto completo  Resumo

Jacobs SS, Krishnan JA, Lederer DJ, et al. Home oxygen therapy for adults with chronic lung disease. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020 Nov 15;202(10):e121-41. [Erratum in: Am J Respir Crit Care Med. 2021 Apr 15;203(8):1045-6.]Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível aqui.

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