Chronic obstructive pulmonary disease (COPD) is a common lung disease characterized by persistent respiratory symptoms and airflow limitation caused by significant exposure to noxious particles or gases. The document discusses the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy for diagnosing, managing, and preventing COPD. It defines COPD and describes the diagnostic criteria, including symptoms, spirometry tests to measure airflow limitation, additional tests like imaging and biomarkers, and screening for conditions like alpha-1 antitrypsin deficiency. Management approaches covered include pharmacotherapy, pulmonary rehabilitation, oxygen therapy, ventilation support and lung transplantation.

1. Diagnosis PPOK Stabil
Oleh : dr. Mohammad Faridza Setyo Hadikusumah
Supervisor :
Dr. dr. Susanthy Djajalaksana, Sp.P (K)
dr. Aditya Sri Listyoko, Sp.P
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2. Global Strategy for the Diagnosis, Management, and Prevention of
Chronic Obstructive Pulmonary Disease
Teaching
Slide Set
© 2022, 2023 Global Initiative for Chronic Obstructive Lung Disease
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3. Definisi
Chronic obstructive Pulmonary Disease (COPD) is common,
preventable, and treatable disease that is characterized by
persistent respiratory symptoms and airflow limitation that is
due to airway and/or alveolar abnormalities usually caused
by significant exposure to noxious particles or gases (GOLD,
2022)
Chronic obstructive Pulmonary Disease (COPD) is a
heterogeneous lung condition characterized by chronic
respiratory symptoms (dyspnea, cough, sputum production,
exacerbations) due to abnormalities of the airways
(bronchitis, bronchiolitis) and/or alveoli (emphysema) that
cause persistent, often progressive, airflow obstruction
(GOLD, 2023)
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9. Additional Investigation
1. Physiological tests
a. Lung volume
In COPD patients exhibit gas trapping (a rise in residual volume) from early stages of the
disease, and as airflow obstruction worsens, static hyperinflation (an increase in total lung
capacity) occurs, particularly during exercise (dynamic hyperinflation)  documented by
body plethysmograph.
b. Carbon monoxide diffusing capacity if the lung (DLco)
- The single breath DLco measurement evaluates the gas transfer properties of the
respiratory system.
- DLco is used as a complement to the information provided by spirometry.
- In COPD patients, low Dlco values help preclude surgical lung resection in patients with lung
cancer while in smokers without airflow obstruction, values <80% predicted (as a marker of
emphysema) signal an increased risk for developing COPD.
© 2022, 2023 Global Initiative for Chronic Obstructive Lung Disease
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10. Additional Investigation
2. Imaging
a. Chest X-ray : is not useful to established a diagnosis in COPD. Radiological finding may
include lung hyperinflation (Flattened diaphragm and an increase in the volume of the
retrosternal air space), hyperlucency of the lungs, and rapid tapering of the vascular markings
b. Computed tomograph (CT)
3. Alpha-1 Antitripsin Deficiency (AATD)
Diagnosis of COPD should be screened once for AATD, especially in areas with high AATD
prevalence. A low concentration (<20% normal) is highly suggestive of homozygous deficiency.
4. Biomarkers
At present blood eosinophil counts ( 300 cels/L) provide guidance to identify COPD patients
at a higher risk of exacerbations and more likely to benefit from preventive treatment with
inhaled corticosterioids
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Obstructive Lung Disease
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30. Terima Kasih
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