Copyright
©The Author(s) 2017.
World J Respirol. Mar 28, 2017; 7(1): 1-16
Published online Mar 28, 2017. doi: 10.5320/wjr.v7.i1.1
Published online Mar 28, 2017. doi: 10.5320/wjr.v7.i1.1
Table 2 Treatment of chronic obstructive pulmonary disease as defined by computed tomography phenotypes
CT phenotype | CT defining features | Clinical features | Findings | Treatments | Ref. |
Emphysema | ↓ Perc15 Emphysema Centrilobular Panlobular Paraseptal Bullous | Health status | ↓ BMI[2] ↑ SGRQ + MRC[7] | Rehabilitation Nutritional support Palliative care | GOLD 2016[5] |
Exercise tolerance | ↓ 6MWD[2] ↓ pO2↓ pCO2[3] | Rehabilitation Maintenance of physical activity Oxygen | GOLD 2016[5] | ||
Lung function | ↑ TLC ↓ KCO ↓ FEV1/FVC | LAMA/LABA LVRS/BVLS Transplant Bullectomy[11] LVRS[11] | GOLD 2016[5] NICE 2010[11] | ||
Symptoms | ↑ Hb[3] No significant response to ICS[8] | Theophylline Rehabilitation typically MRC > 3 | GOLD 2016[5] NICE 2010[11] | ||
Airways disease | Exacerbation frequency/ severity | ↑ Exacerbations hospital admissions[7] | LABA/phosphodiesterase-4 inhibitor LAMA/phosphodiesterase-4 inhibitor Mucolytics Add in ICS Prophylactic antibiotics | GOLD 2016[5] NICE 2010[11] Brown et al[12], 2007 Fabbri et al[13], 2009 Calverley et al[14], 2009 Herath et al[15], 2013 | |
Lower wall area/body Surface area ratio (WA/BSA) Lower luminal area/BSA Higher %WA | Symptoms | Significant response to ICS+ Significantly higher % of sputum eosinophils[8] Peribronchial thickening[10] Air trapping | Physiotherapy and active breathing techniques Mucolytics Roflumilast Bronchodilators | NICE 2010[11] |
- Citation: Crossley D, Turner A, Subramanian D. Phenotyping emphysema and airways disease: Clinical value of quantitative radiological techniques. World J Respirol 2017; 7(1): 1-16
- URL: https://www.wjgnet.com/2218-6255/full/v7/i1/1.htm
- DOI: https://dx.doi.org/10.5320/wjr.v7.i1.1