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Última revisão: 14 Aug 2025
Última atualização: 13 May 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

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

Outros fatores diagnósticos

  • 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

Fatores de risco

  • 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

Investigações diagnósticas

Primeiras investigações a serem solicitadas

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

Investigações a serem consideradas

  • 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

Algoritmo de tratamento

Colaboradores

Autores

Manoochehr Abadian Sharifabad, MD
Manoochehr Abadian Sharifabad

Fountain Valley Regional Medical Center

Fountain Valley

CA

Declarações

MAS declares that he has no competing interests.

Agradecimentos

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

Declarações

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

Revisores

Hormoz Ashtyani, MD, FCCP

Hackensack University Medical Center

Hackensack

NJ

Declarações

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

Declarações

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

Declarações

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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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