Chronic Obstructive Pulmonary Disease (COPD)
(Last Updated - 5/17/2007)
GOLD Staging System:
Stage:
Classification:
Characteristics:
0
At Risk
-Normal Spirometry
-Chronic symptoms (cough and/or sputum)
1
Mild
-FEV1 / FVC < 70%
-FEV1 >= 80% predicted
-W/ or w/out chronic symptoms (cough and/or sputum)
2
Moderate
-FEV1 / FVC < 70%
-FEV1 >= 50% but < 80% predicted
-W/ or w/out chronic symptoms (cough and/or sputum)
3
Severe
-FEV1 / FVC < 70%
-FEV1 >= 30% but < 50% predicted
-W/ or w/out chronic symptoms (cough and/or sputum)
4
End-Stage
-FEV1 / FVC < 70%
(Very Severe)
-FEV1 < 30% predicted OR FEV1 < 50% predicted w/ resp. failure
-Resp. Failure:
-PaO2 < 60mm Hg w/ or w/out PaCO2 > 50mm Hg while breathing air @ sea level
-COPD Exacerbation Steroid Taper Regimen (NEJM - 6/24/1999 (340, #25 - p. 1941-1947):
1) IV Solucortef 125 mg Q6H x 72 hrs then
2) Prednisone 60 PO QDay x4 days then
3) 40 PO QDay x4 days then
4) 20 PO QDay x4 days then
5) Off
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References:
1) NEJM - 6/24/1999 (340, #25 - p. 1941-1947)