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Última revisión: 10 Dec 2025
Última actualización: 13 May 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

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

Otros factores de diagnóstico

  • 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

Factores de riesgo

  • 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

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

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

Pruebas diagnósticas que deben considerarse

  • 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 tratamiento

Colaboradores

Autores

Manoochehr Abadian Sharifabad, MD
Manoochehr Abadian Sharifabad

Fountain Valley Regional Medical Center

Fountain Valley

CA

Divulgaciones

MAS declares that he has no competing interests.

Agradecimientos

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

Divulgaciones

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

Revisores por pares

Hormoz Ashtyani, MD, FCCP

Hackensack University Medical Center

Hackensack

NJ

Divulgaciones

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

Divulgaciones

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

Divulgaciones

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

Divulgaciones

FT declares that he has no competing interests.

Agradecimiento de los revisores por pares

Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.

Divulgaciones

Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

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  Resumen

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  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible aquí.

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