Putcha Nirupama, Maselli Diego J, Bon Jessica, Lester Michael G, Drummond M Bradley
Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Pulmonary Diseases & Critical Care, Department of Medicine, University of Texas Health, San Antonio, TX, USA.
Pulm Ther. 2025 Sep 27. doi: 10.1007/s41030-025-00318-x.
Chronic obstructive pulmonary disease (COPD) is a multifaceted lung condition characterized by persistent airflow limitation that leads to chronic symptoms, including dyspnea, cough, and exacerbations. To date, a major focus for the assessment and management of COPD has been on mitigating exacerbations. However, dyspnea is the most common symptom of COPD and is responsible for substantial negative effects on patients' quality of life. Dyspnea is also a substantial contributor to the symptoms associated with acute exacerbations in COPD. Though a portion of the current recommendations for the assessment and management of COPD are dedicated to dyspnea treatment intervention strategies, there remains a need for improvement in communication between healthcare practitioners and their patients regarding the understanding of dyspnea and the implementation of key nonpharmacologic and pharmacologic treatment options. This clinical commentary outlines practical considerations and recommendations for the real-world assessment and management of dyspnea in COPD, including underlying causes, patient and healthcare provider dialogue, measurement of severity, and management strategies.
慢性阻塞性肺疾病（COPD）是一种多方面的肺部疾病，其特征是气流持续受限，导致慢性症状，包括呼吸困难、咳嗽和急性加重。迄今为止，COPD评估和管理的主要重点一直是减轻急性加重。然而，呼吸困难是COPD最常见的症状，对患者的生活质量有重大负面影响。呼吸困难也是COPD急性加重相关症状的重要促成因素。尽管目前关于COPD评估和管理的部分建议致力于呼吸困难治疗干预策略，但在医疗从业者与患者之间就呼吸困难的理解以及关键非药物和药物治疗方案的实施进行沟通方面仍有改进的必要。本临床评论概述了COPD中呼吸困难实际评估和管理的实际考虑因素和建议，包括潜在原因、患者与医疗服务提供者的对话、严重程度的测量以及管理策略。
