Chronic Obstructive Pulmonary Disease
Global Strategy for the diagnosis, management and prevention of COPD (2016) Update

NICE guideline [CG101] Chronic obstructive pulmonary disease in over 16s: diagnosis and management (June 2010)

BTS GUIDELINE (2007) Intermediate care—Hospital-at-Home in COPD. Thorax, 62, 200-210



RCP (2008) National COPD Audit. Royal College of Physicians and British Thoracic Society

UK Department of Health (2010) - Consultation on a Strategy for Services for COPD in England
• 3 million people have COPD but only 2 million are diagnosed (England)
• re-admissions rising
• patients with respiratory failure should carry alert cards
• 25% of patients are unable to work due to the disease
• people in lowest social groups are 14 times more likely to have COPD
• up to 30% patients currently prescribed LTOT derive no benefit from it, but only half of eligible patients with severe disease receive it

UK Department of Health (2011) - An outcomes strategy for people with COPD and asthma

COPD Assessment Test (CAT)
• self assessment based on shortened St. George’s Questionnaire.



Resource for health staff:

Abdellaoui A, Préfaut C, Gouzi F et al (2011) Skeletal muscle effects of electrostimulation after COPD exacerbation: a pilot study. Eur Respir J, 38, 781-788
• electrostimulation helps maintain walking distance

Abdool-Gaffar MS, Ambaram A, Ainslie GM et al (2011) Guideline for the management of chronic obstructive pulmonary disease – 2011 update. S Afr Med J, 101, 1, 61-73

Agusti A, Hedner J, Marin JM et al (2011) Night-time symptoms: a forgotten dimension of COPD. Eur Respir Rev, 20,183-194. doi:10.1183/09059180.00004311

Agusti A, Gea J, Faner R et al (2016) Biomarkers, the control panel and personalized COPD medicine. Respirology; 21(1):24-33. doi: 10.1111/resp.12585

Albarrati AM, Gale NS, Enright S (2016) A simple and rapid test of physical performance in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis; 11:1785-91. doi: 10.2147/COPD.S106151

Al-Gibouri S, Ringbæk T, Lange P (2013) Neuromuscular electrical stimulation improves the functional level in patients with severe chronic obstructive pulmonary disease. Ugeskr Laeger;175(17):1185-8

Allinson JP, Hardy R, Donaldson GC et al (2016) The presence of chronic mucus hypersecretion across adult life in relation to chronic obstructive pulmonary disease development. Am J Respir Crit Care Med; 193(6):662-672

Anami K, Horie J, Shiranita S-I et al (2013) The factors involved the depression in patients with chronic obstructive pulmonary disease. Jap J Health Promotion Phys Ther; 3(2):65-69

Annegarn J, Spruit MA, Savelberg HHCM et al (2012) Differences in walking pattern during 6-min walk test between patients with COPD and healthy subjects. PLoS One, 7, 5, e37329. doi: 10.1371/journal.pone.0037329

Apps LD, Mitchell KE, Harrison SL et al (2013) The development and pilot testing of the Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD). Int J Chron Obstruct Pulmon Dis, 8, 317-27. doi: 10.2147/COPD.S40414

Aquino G, Iuliano E, di Cagno A et al (2016) Effects of combined training vs aerobic training on cognitive functions in COPD: a randomized controlled trial. Internat J COPD; 11:711-718. doi: 10.2147/COPD.S96663

Arnardottir RH (2007) No increase in walking distance on repeated tests in COPD patients with exercise-induced hypoxaemia. Advances Physiother, 9, 4, 161 – 168
• when using the 12-min walking distance, a practice walk is needed only in those patients who do not desaturate on exercise.

Bahadori K et al (2007) Risk factors of hospitalization and readmission of patients with COPD exacerbation – systematic review. Int J Chron Obstruct Pulmon Dis.2(3): 241–251

Bakerly ND (2009) Cost analysis of an integrated care model in the management of acute exacerbations of COPD. Chr Respir Dis, 6, 4, 201-8
• hospital-at-home management of COPD exacerbations saves £600 per patient.

Balbi B, Ferrarotti I, Miravitlles M (2016) Efficacy of augmentation therapy for emphysema associated with α1-antitrypsin deficiency: enough is enough. Eur Respir J; 47(1):35-8. doi: 10.1183/13993003.01145-2015.

Balmes JR (2012) When smoke gets in your lungs. Proc Am Thorac Soc, 7, 2, 98–101
• in the developing world smoke due to inefficient cooking with biomass fuels in poorly ventilated homes is a major cause of COPD

Ban A, Ismail A, Harun R et al (2012) Impact of clinical pathway on clinical outcomes in the management of COPD exacerbation. BMC Pulm Med, 12, 27. doi: 10.1186/1471-2466-12-27

Barker AF (2010) Alpha-1 antitrypsin deficiency identification and management. COPD, 7, 3, 162-3
• AATD takes an average 6 years to be diagnosed
• diagnosis and treatment of AATD

Barreiro E, Sieck G (2013) Muscle dysfunction in COPD. J Appl Phys; 114(9):1220-1221. doi: 10.1152/japplphysiol.00162.2013
• muscle dysfunction is a predictor of mortality and affects respiratory and limb muscles, including weak quadriceps in a third of patients with even mild disease

Barros de Sá R (2017) Immediate effects of respiratory muscle stretching on chest wall kinematics and electromyography in COPD patients. Resp Physiol Neurobiol; 241:1-7

Bastin AJ, Starling L, Ahmed R (2010) High prevalence of undiagnosed and severe chronic obstructive pulmonary disease at first hospital admission with acute exacerbation. Chronic Resp Dis, 7, 2, 91-97
• fewer than one in five patients are diagnosed
• diagnosis was not made prior to admission in one-third of patients with severe disease
• self management plans are associated with reduced admissions
• one third of patients were not seen by the respiratory team during their admission
• PR is safe after exacerbations
• stopping smoking reduces mortality even in patients with severe COPD

Baz M, Haji GS, Menzies-Gow A et al (2015) Dynamic laryngeal narrowing during exercise: a mechanism for generating intrinsic PEEP in COPD? Thorax; 70(3):251-7. doi: 10.1136/thoraxjnl-2014-205940

Berton DC, Castro MA, Merola P et al (2016) Inspiratory loading and limb blood flow in copd: the modulating effects of resting lung hyperinflation. Respir Physiol Neurobiol. Mar 7. pii: S1569-9048(16)30021-0. doi: 10.1016/j.resp.2016.03.004

Beekman E, Mesters I, Hendriks EJ et al (2014) Exacerbations in patients with chronic obstructive pulmonary disease receiving physical therapy: a cohort-nested randomised controlled trial. BMC Pulm Med; 14:71. doi: 10.1186/1471-2466-14-71

Behnke M (2000) Home-based exercise is capable of preserving hospital-based improvements in severe COPD. Respir Med, 94, 1184-91

Bekkering GE (2000) Guidelines for physiotherapeutic management in COPD. Phys Ther Rev, 5, 59-74
• comprehensive, physiologically-sound guidelines, including flow-charts

Bellamy D Freeman D (2000) Chronic obstructive pulmonary disease. Prim Care Respir J, 9, S20-21
• steroids are usually beneficial for exacerbations but unhelpful in the stable state

Bellone A (2002) Short-term effects of expiration under positive pressure in patients with acute COPD and mild acidosis requiring NIV. Int Care Med, 28, 581-5
• expiration under positive pressure helps clear secretions in this group of patients

Berry JK (2001) Malnutrition in COPD: adding insult to injury. AACN Clin Issues, 12, 210-19
• mechanisms and management

Bégin P (2000) Chronic hypoventilation helps to maintain the inspiratory muscle effort of COPD patients. Chest, 117, 271S-273S
• the purpose of chronic hypoventilation (common in Type 2 respiratory failure) may be to preserve the respiratory muscles

Bhatt SP, Wells JM, Kinney GL et al (2016) β-Blockers are associated with a reduction in COPD exacerbations. Thorax; 71(1):8-14. doi: 10.1136/thoraxjnl-2015-207251

Bhatt SP (2013) Noninvasive positive pressure ventilation in subjects with stable COPD: a randomized trial. Int J Chron Obstruct Pulmon Dis, 8: 581-589
• noninvasive ventilation at home may improve gas exchange and quality of life

Bhatt SP, Terry NL, Nath H et al (2016) Association between expiratory central airway collapse and respiratory outcomes among smokers. JAMA; 315(5):498-505. doi: 10.1001/jama.2015.19431

Bhatt SP, Wells JM, Kinney JL et al (2016) β-Blockers are associated with a reduction in COPD exacerbations. Thorax; 71(1):8-14. doi:10.1136/thoraxjnl-2015-207251

Burtin C, Riet G, Puhan MA et al (2016) Handgrip weakness and mortality risk in COPD: a multicentre analysis. Thorax; 71(1):86-87. doi:10.1136/thoraxjnl-2015-207451
• handgrip strength is associated with mortality

Biskobing DM (2002) COPD and osteoporosis. Chest, 121, 609-620
• many patients are not diagnosed as having osteoporosis until they get a fracture

Bon JM (2010) Plasma inflammatory mediators associated with bone metabolism in COPD. COPD, 7, 3, 186-191
• osteoporosis is a significant problem in COPD

Bonilha AG et al (2009) Effects of singing classes on pulmonary function and quality of life of COPD patients. Int J Chron Obstruct Pulmon Dis, 4, 1–8

Bourbeau J, Sedeno MF, Metz K et al (2016) Early COPD exacerbation treatment with combination of ICS and LABA for patients presenting with mild-to-moderate worsening of dyspnea. COPD; 13(4):439-47. doi: 10.3109/15412555.2015.1101435

Brijker F, Heijdra YF, Van den Elshout et al (2002) Discontinuation of furosemide decreases PaCO2 in patients with COPD. Chest, 121, 377-82
• furosemide can cause metabolic acidosis.

Brown JP, Martinez CH (2016) Chronic obstructive pulmonary disease comorbidities. Curr Opin Pulm Med; 22(2):113-8. doi: 10.1097/MCP.0000000000000241

BTS (2007) Intermediate care - hospital-at-home in chronic obstructive pulmonary disease: British Thoracic Society guideline. Thorax, 62, 200-10

Bucknall CE, Miller G, Lloyd SM et al (2012) Glasgow supported self-management trial (GSuST) for patients with moderate to severe COPD: randomised controlled trial. BMJ, 344, e1060. doi: 10.1136/bmj.e1060

Burge AT, Lee AL, Kein C et al (2017) Prevalence and impact of urinary incontinence in men with chronic obstructive pulmonary disease: a questionnaire survey. Physiotherapy; 103(1):53–58. doi:

Burtin C, Ter Riet G, Puhan MA et al (2016) Handgrip weakness and mortality risk in COPD: a multicentre analysis. Thorax; 71(1):86-7. doi: 10.1136/thoraxjnl-2015-207451

Cahalin LP (2002) Efficacy of diaphragmatic breathing in persons with COPD: a review of the literature. J Cardiopulm.Rehab, 22, 7-21
• rationale of why diaphragmatic breathing may or may not be effective

Carter R, Holiday DB (2003) Predicting oxygen uptake for men and women with moderate to severe COPD. Arch Phys Med Rehab, 84, 1158-64
• estimation of VO2 from six-minute walk test

Casas A, Troosters T, Garcia-Aymerich J, et al (2006) Integrated care prevents hospitalisations for exacerbations in COPD patients. Eur Respir J, 28,123–130
• individually tailored care plan on discharge, shared with primary care team and specialist nurse via a web-based call centre, reduces hospitalisation

Chatwin M, Hawkins G, Panicchia L et al (2016) Randomised crossover trial of telemonitoring in chronic respiratory patients. Thorax; 71(4):305-311. doi: 10.1136/thoraxjnl-2015-207045
• telemonitoring has not yet proved cost-effective

Chen S, Li Y, Zheng Z, Luo Q et al (2016b) The analysis of components that lead to increased work of breathing in chronic obstructive pulmonary disease patients. J Thoracic Dis; 8(8):2212-2218. doi: 10.21037/jtd.2016.08.01.
• airflow resistance is the main contributor to SOB at rest, and hyperinflation the main contributor on exercise

Cherniack NS (2002) Singing the COPD blues. Respiration, 69, 115-16
• a short sweet reminder of the mechanism of long term oxygen to prevent organ damage

Chaplin EJL (2013) Neuromuscular stimulation of quadriceps in patients hospitalised during an exacerbation of COPD: a comparison of low (35 Hz) and high (50 Hz) frequencies. Physiother Res Internat, 18(3):148–156. doi: 10.1002/pri.1541.

Chilosi M, Poletti V, Rossi A et al (2012) The pathogenesis of COPD and IPF: Distinct horns of the same devil? Respir Res, 13, 1, 3

Chow JW, Khullar K, Katechia K et al (2016) Controlled oxygen therapy at emergency department presentation increases the likelihood of achieving target oxygen saturations in patients with exacerbations of chronic obstructive pulmonary disease. Emerg Med Austr; 28(1):44-7. doi: 10.1111/1742-6723.12528
• in acute COPD patients, only 16% achieved their target SpO2

Chung LP, Lake F, Hyde E et al (2016) Integrated multidisciplinary community service for chronic obstructive pulmonary disease reduces hospitalisations. Intern Med J; 46(4):427-34. doi: 10.1111/imj.12984
• multidisciplinary community programme reduces respiratory admissions, more so in patients who have completed pulmonary rehabilitation

Constantin D, Menon MK, Houchen-Wolloff L et al (2013) Skeletal muscle molecular responses to resistance training and dietary supplementation in COPD. Thorax; 68(7):625-33

Cooke CE (2012) Review: Clinical inertia in the management of Chronic Obstructive Pulmonary Disease. COPD, 9, 1, 73–80
• COPD is the third biggest killer in the US

Cooper CB, Calligaro GL, Quinn MM et al (2014) Determinants of dynamic hyperinflation during metronome-paced tachypnea in COPD and normal subjects. Resp Physiol Neurobiol; 190(1):76-80

Contou D, Fragnoli C, Córdoba-Izquierdo A et al (2014) Noninvasive ventilation for acute hypercapnic respiratory
failure: intubation rate in an experienced unit. Respir Care; 59(1):2045–2052

Coronell C (2004) Relevance of assessing quadriceps endurance in patients with COPD. Eur Respir J, 24,129-136
• impaired quadriceps endurance is present in COPD patients even if they have mild airflow obstruction, indicating that other factors as well as deconditioning are responsible

Couillard A, Muir JF, Veale D (2010) COPD recent findings: impact on clinical practice. COPD, 7, 3, 204-213
• co-morbidities - muscle dysfunction, nutritional and endocrine dysfunction, anaemia, osteoporosis, and cardiovascular and metabolic disorders

Cross J (2012) Chest physiotherapy during an acute exacerbation of chronic obstructive pulmonary disease. Chronic Resp Dis, 9, 2, 73-75

Dag E, Bulcun E, Turkel Y et al (2016) Factors influencing cognitive function in subjects with COPD. Respir Care; 61(8):1044-1050
• cerebral hypoxia secondary to hypoxaemia contributes to cognitive impairment, which is thought to progress to dementia in over half of patients within 3-5 yrs

Dagan N (2017) External validation and comparison of three prediction tools for risk of osteoporotic fractures using data from population based electronic health records: retrospective cohort study. BMJ; 356:i6755. doi:

Dahlén I, Janson C (2002) Anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease. Chest, 122, 1633-7
• significant association between treatment failure and anxiety and/or depression

Dal Negro RW, Celli BR (2016) The BODECOST Index (BCI): a composite index for assessing the impact of COPD in real life. Multidiscip Respir Med; 11:10. doi: 10.1186/s40248-016-0045-4.

De Araujo CL et al (2016) Pursed-lips breathing reduces dynamic hyperinflation induced by activities of daily living test in patients with chronic obstructive pulmonary disease. J Rehabil Med; 47(10):957-62.
• pursed-lips breathing may reduce dynamic hyperinflation, but do not improve functional capacity:

Decramer M, Janssens W, Miravitlles M (2012) Chronic obstructive pulmonary disease. Lancet, 379, 9823

Decramer ML, Hanania NA, Lötvall JO (2013) The safety of long-acting β2-agonists in the treatment of stable chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 8, 53–64. doi:10.2147/COPD.S39018

De Godoy DV (2003) A randomized controlled trial of the effect of psychotherapy on anxiety and depression in COPD. Arch Phys Med Rehab, 84, 1154-7

Dekhuijzen PN (2006) Acetylcysteine in the treatment of severe COPD. Dekhuijzen Ned Tijdschr Geneeskd, 150, 22, 1222-6.
• mucolytics can reduce exacerbations

De Miguel-Díez J (2010) The influence of heart disease on characteristics, quality of life, use of health resources, and costs of COPD in primary care settings. BMC Cardiovasc Dis, 10, 8
• patients with heart disease as a comorbidity show worse quality of life and increased consumption of drugs

Derdak S (2017) Prevention of COPD readmissions: a work in progress. Respir Care; 62(1):133-134

de Souza GF (2010) Lactic acid levels in patients with chronic obstructive pulmonary disease accomplishing unsupported arm exercises. Chronic Resp Dis, 7, 2, 75-82
• extra energy, equivalent to 50% of the peak required for maximal leg exercises, is needed for unsupported arm exercises to compensate for dyssynchronous contraction of the different ventilatory muscle compartments

Díaz AA et al (2013) CT and physiologic determinants of dyspnea and exercise capacity during the six-minute walk test in mild COPD. Respir Med, 107, 4, 570-579

DiBonaventura MD (2012) The impact of COPD on quality of life, productivity loss, and resource use among the elderly United States workforce. COPD, 9, 1, 46-57

Dodd JW, Marns PL, Clark AL et al (2012) The COPD Assessment Test (CAT): short- and medium-term response to pulmonary rehabilitation. COPD, 9, 4, 390–394

Dolmage TE, Janaudis-Ferreira T, Hill K et al (2013) Arm elevation and coordinated breathing strategies in patients with COPD. Chest; 144(1):128-35. doi: 10.1378/chest.12-2467.
• exhalation should be co-ordinated with arm elevation

Donesky-Cuenco D, Nguyen HQ, Paul S, Carrieri-Kohlman V (2009) Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: a pilot study. J Altern Complement Med, 15, 3, 225-34

Dowson CA, Kuijer RG, Town IG (2010) Impact of panic disorder upon self-management educational goals in chronic obstructive pulmonary disease? Chronic Respir Dis, 7, 2, 83-90
• 24%–50% of hospitalized patients with COPD have panic disorder, compared to 10%–19% in general medical inpatients

Dritsaki M, Johnson-Warrington, K, Mitchell K et al (2016) An economic evaluation of a self-management programme of activity, coping and education for patients with chronic obstructive pulmonary disease. Chron Respir Dis; 13(1):48-56. doi: 10.1177/1479972315619578
• a self-management programme is cost-effective

Du Q, Jin J, Liu X, Sun Y (2016) Bronchiectasis as a comorbidity of chronic obstructive pulmonary disease: a systematic review and meta-analysis. PLoS One; 11(3):e0150532. doi: 10.1371/journal.pone.0150532

Echevarria C, Brewin K, Horobin H et al (2016) Early supported discharge/hospital at home for acute exacerbation of chronic obstructive pulmonary disease: a review and meta-analysis. COPD; 13(4):523-33. doi: 10.3109/15412555.2015.1067885

Echevarria C, Steer J, Heslop-Marshall K et al (2016) Validation of the DECAF score to predict hospital mortality in acute exacerbations of COPD. Thorax; 71(2):133-140. doi: 10.1136/thoraxjnl-2015-207775

Effing TW, Vercoulen JH, Bourbeau J et al (2016) Definition of a COPD self-management intervention: International Expert Group consensus. Eur Respir J; 48(1):46-54. doi: 10.1183/13993003.00025-2016

Ekici A, Bulcun E, Karakoc T et al (2015) Factors associated with quality of life in subjects with stable COPD. Respir Care; 60(11):1585-1591

Emtner M, Wadell K (2016) Effects of exercise training in patients with chronic obstructive pulmonary disease-a narrative review for FYSS. Br J Sports Med; 50(6):368-71. doi: 10.1136/bjsports-2015-095872

Engel R, Vemulpad S (2011) The role of spinal manipulation, soft-tissue therapy, and exercise in chronic obstructive pulmonary disease: a review of the literature and proposal of an anatomical explanation. J Altern Complement Med; 17(9):797-801. doi: 10.1089/acm.2010.0517

Farkhooy A (2013) Impaired Carbon Monoxide Diffusing Capacity is the strongest predictor of exercise intolerance in COPD. COPD, 10(2):180–185. doi:10.3109/15412555.2012.734873

Farquhar M (2010) Diversity of experience and impacts of caring for a patient with breathlessness in advanced COPD. Palliat Med, 24, 2, 211

Fernandes M, Cukier A, Feltrim MIZ (2011) Efficacy of diaphragmatic breathing in patients with chronic obstructive pulmonary disease. Chron Respir Dis, 8, 237-44
• diaphragmatic breathing reduces SOB and hypoxaemia in the majority of COPD patients, but in some patients with severe COPD it may cause asynchronous breathing thus worsening SOB

Ferreira TC, Sampaio EP, Argañaraz GA et al (2014) Increased prevalence of the alpha-1-antitrypsin (A1AT) deficiency-related S gene in patients infected with human immunodeficiency virus type 1. J Med Virol; 86(1):23-9. doi: 10.1002/jmv.23759

Figueiredo D, Gabriel R, Jácome C (2014) Caring for people with early and advanced chronic obstructive pulmonary disease: how do family carers cope? J Clin Nurs; 23(1-2):211–20)

Frisk B, Espehaug B, Hardie JA et al (2014) Physical activity and longitudinal change in 6-min walk distance in COPD patients. Respir Med; 108(1):86-94

Frølich A (2012) Impact of exercise capacity on dyspnea and health-related quality of life in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehab Prev, 32, 2, 92-100

Gagliardi E (2014) Thoraco-abdominal motion/displacement does not affect dyspnea following exercise training in COPD patients. Resp Physiol Neurobiol; 190(1):124-130

Garvey C (2016) Recent updates in chronic obstructive pulmonary disease.
Postgrad Med; 128(2):231-8. doi: 10.1080/00325481.2016.1118352

Gauvain C, Mornex J-F, Pison C et al (2015) Health-related quality of life in patients with alpha-1 antitrypsin deficiency: the French experience. COPD; 12, S1: 46-51. doi:10.3109/15412555.2015.1022645
• breathlessness has the greatest impact on quality of life in patients with alpha-1 antitrypsin deficiency

Gea J, Pascual S, Casadevall C et al (2016) Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings. J Thoracic Dis; 7(10):E418-E438. doi: 10.3978/j.issn.2072-1439.2015.08.04.

Greulich T (2017) The prevalence of diagnosed α1-antitrypsin deficiency and its comorbidities: results from a large population-based database. Eur Respir J; 49(1): 1600154. doi: 10.1183/13993003.00154-2016
• comorbidities of α1-antitrypsin deficiency include hypertension, kidney disease and diabetes

Gosselink R (2004) Breathing techniques in patients with COPD. Chronic Respir Dis, 1, 163-72

Guarnieri G (2010) Effects of inhalation of thermal water on exhaled breath condensate in chronic obstructive pulmonary disease. Respiration, 79, 216-221

Guffey JS, Motts S, Barymon D et al (2016) Using near infrared light to manage symptoms associated with restless legs syndrome. Physiother Theory Pract; 32(1):34-44. doi:10.3109/09593985.2015.1087613

Guillien A, Puyraveau M, Soumagne T et al (2016) Prevalence and risk factors for COPD in farmers: a cross-sectional controlled study. Eur Respir J; 47(1):95-103. doi: 10.1183/13993003.00153-2015

Gulbas G, Kaplan Y, Kamisli O et al (2013) Neuromuscular transmission in hypoxemic patients with chronic obstructive pulmonary disease. Resp Physiol Neurobiol; 189(1):112-116

Hajizadeh N, Goldfeld K, Crothers K (2015) What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study. Thorax;70:294-6. doi:10.1136/thoraxjnl-2014-205248
• patients die mainly from cardiovascular disease
• mechanical ventilation brings high mortality

Hansel NN, MC McCormack, Kim V et al (2016) The effects of air pollution and temperature on COPD. COPD; 13:3:372-379. doi: 10.3109/15412555.2015.1089846

Hartl S, Lopez-Campos JL, Pozo-Rodriguez F et al (2016) Risk of death and readmission of hospital-admitted COPD exacerbations: European COPD audit. Eur Respir J; 47(1):113-21. doi: 10.1183/13993003.01391-2014

Hatipoglu US (2016) Treating and preventing acute exacerbations of COPD. Cleve Clin J Med; 83(4):289-300. doi: 10.3949/ccjm.83a.14188

Hayes D, Black SM, Tobias JD et al (2016) Prevalence of pulmonary hypertension and its influence on survival in patients with advanced chronic obstructive pulmonary disease prior to lung transplantation. COPD, 13(1): 50-56. doi: 10.3109/15412555.2015.1043425

Heunks MA, Abdo WF (2012) Oxygen-induced hypercapnia in COPD:
myths and facts. Crit Care, 16, 323-6

Hitchings AW, Baker EH (2016) Avoiding unnecessary arterial blood sampling in COPD exacerbations: a stab in the right direction. Thorax; 71(3):208-209. doi: 10.1136/thoraxjnl-2015-208205

Holland AE, Button BM (2006) Is there a role for airway clearance techniques in chronic obstructive pulmonary disease? Chronic Respir Dis, 3, 2, 83-91
• PEP and autogenic drainage thought to be effective, but it may be advisable to avoid techniques that involve forced expiration

Huang SW, Wang WT, Chou LC et al (2016) Chronic obstructive pulmonary disease increases the risk of hip fracture: a nationwide population-based cohort study. Sci Rep; 6:23360. doi: 10.1038/srep23360

Itoh M, Tsuji T, Nemoto K (2013) Undernutrition in patients with COPD and its treatment. Nutrients, 18, 5, 4, 1316-35. doi: 10.3390/nu5041316

Jacome C, Marques A (2015) Computerized respiratory sounds are a reliable marker in subjects with COPD. Respir Care; 60(9):1264-1275
• COPD shows inspiratory crackles and expiratory wheezes

Janssen DJA, Spruit MA, Does JD (2010) End-of-life care in a COPD patient awaiting lung transplantation. BMC Palliative Care, 9, 6

Janssen DJ, Wouters EF, Parra YL et al (2016) Prevalence of thoracic pain in patients with chronic obstructive pulmonary disease and relationship with patient characteristics: a cross-sectional observational study. BMC Pulm Med; 16:47. doi: 10.1186/s12890-016-0210-8
• thoracic pain is reported in 21–77 % of patients
• positive relationship between pain and dyspnoea severity - physical deconditioning might be the explanation for the relationship between breathlessness and pain, or both symptoms could be the results of the same underlying process
• under treatment has been reported
• systematic assessment and treatment of thoracic pain should be standard

Javadzadeh S, Chowienczyk S, Booth S et al (2016) Comparison of respiratory health-related quality of life in patients with intractable breathlessness due to advanced cancer or advanced COPD. BMJ Support Palliat Care. 2016 Mar;6(1):105-8. doi: 10.1136/bmjspcare-2015-000949
• patients with breathlessness due to advanced COPD have worse respiratory HRQoL than those with advanced cancer
• greater access to palliative care is needed in advanced COPD

Jones GL (2016) Quality of life changes over time in patients with chronic obstructive pulmonary disease. Curr Opin Pulm Med; 22(2):125-9. doi: 10.1097/MCP.0000000000000242
• symptoms and activity levels are as important as FEV1 in determining disease severity, QoL and prognosis
• small sustained increases in physical activity may slow physical deterioration and improve health-related QoL.

Jones AYM, Dean E, Chow CCS (2003) Comparison of the oxygen cost of breathing exercises with spontaneous breathing in patients with stable COPD. Phys Ther, 83, 424-31
• abdominal breathing and pursed lip breathing reduce oxygen cost of breathing, but this is not maintained

Jones SE, MaddocksM, Don SSC et al (2015) Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation. Thorax; 5(70):213-218. doi:10.1136/thoraxjnl-2014-206440
• sarcopaenia sometimes reversible by pulmonary rehabilitation

Jones GL (2016) Quality of life changes over time in patients with chronic obstructive pulmonary disease. Curr Opin Pulm Med; 22(2):125-9. doi: 10.1097/MCP.0000000000000242
• symptoms and activity levels are as important as FEV1 in determining disease severity, QoL and prognosis
• small sustained increases in physical activity may slow physical deterioration and improve health-related QoL.

Jones RL, Noble PB, Elliot JG (2016) Airway remodelling in COPD: It's not asthma! Respirology ; 21(8):1347-1356. doi: 10.1111/resp.12841

Jorine E (2013) Physical and psychosocial factors associated with physical activity in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil, 94(12):2396-402.e7

Kakizaki F et al (1999) Preliminary report on the effects of respiratory muscle stretch on chest wall mobility in COPD. Respir Care, 44, 409-414

Katz P, Iribarren C, Sanchez G et al (2016) Obesity and functioning among individuals with chronic obstructive pulmonary disease. COPD; 13(3): 352-359. doi: 10.3109/15412555.2015.1087991

Knebel AR, Bentz E, Barnes P (2000) Dyspnea management in alpha-1 antitrypsin deficiency. Nurs Res, 49, 333-8

Ko FW, Cheung NK, Rainer TH et al (2017) Comprehensive care programme for patients with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax; 72:122-8 doi:10.1136/thoraxjnl-2016-208396

Kvangarsnes M, Torheim H, Rotheim H et al 2013) Narratives of breathlessness in chronic obstructive pulmonary disease. J Clin Nurs; 22(21-22):3062–3070. doi: 10.1111/jocn.12033

Lahousse L, Verhamme KM, Stricker BH et al (2016) Cardiac effects of current treatments of chronic obstructive pulmonary disease. Lancet Respir Med; 4(2):149-64. doi: 10.1016/S2213-2600(15)00518-4.

Littleton SW (2015) Hypercapnia from hyperoxia in COPD: another piece of the puzzle or another puzzle entirely? Respir Care; 60(3):473-475

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ACPRC = Association of Chartered Physiotherapists in Respiratory Care
ADL = activities of daily living
BMJ = British Medical Journal
BTS = British Thoracic Society
CVS = cardiovascular system
FEV1,= forced expiratory volume in one second
FRC = functional residual capacity
HRQL = health-related quality of life
IMT = inspiratory muscle training
IPPB = intermittent positive pressure breathing
MI = myocardial infarct
MRC = Medical Research Council
NEJM = New England Journal of Medicine
NICE = National Institute for Health and Clinical Excellence
NIV = non-invasive ventilation
PEP = positive expiratory pressure
PLB = pursed lips breathing
PR = pulmonary rehabilitation
QoL = quality of life
RFT = respiratory function test
SOB = shortness of breath
VO2 = oxygen consumption