Chronic obstructive pulmonary disease (COPD) is a lung disorder characterized by emphysema and chronic bronchitis. This means the walls between the tiny air sacs in the lungs become damaged and lose their elasticity. In addition, the lining of the airways become chronically irritated and there is an increase in the amount of mucus produced. Cigarette smoking is the most common cause. COPD worsens over time and the later stages can be quite debilitating.
Lung Involvement
Spirometry is a test that measures lung function. COPD is characterized by decreases in the total amount of air the lungs can move and the volume of air that is exhaled. These tests worsen as the disease advances. In addition, the lungs ability to handle oxygen declines and blood oxygen levels fall. Many patients require supplemental oxygen to compensate.
Cough is one of the more common symptoms of end stage COPD. This may be dry and irritating or produce lots of thick mucus. Many patients have trouble clearing out phlegm and mucus due to the weakness of the lungs. The National Heart Lung and Blood Institute notes shortness of breath, wheezing and chest tightness as symptoms of COPD. These problems may progress to the point that even minimal exertion causes breathing difficulties.
People with COPD are more prone to lung infections. Pneumonia and influenza can be life-threatening. Pneumothorax, or an air leak from the lung, may complicate breathing. The rate of lung cancer is increased in those with COPD.
Other Organ Involvement
One complication of end stage COPD is heart failure, states Emedicine.com. This may present with ankle swelling and a worsening ability to tolerate exertion. Low blood oxygen may lead to confusion or decreased alertness. It may also cause lips and fingers to turn blue. National Jewish Health notes some sleeping issues in COPD sufferers. People may prefer to sit up to ease breathing and poor sleep may contribute to excessive fatigue.
End of Life Issues
Mechanical support of breathing is an issue that those afflicted with the end stages of COPD need to consider. This can be "non-invasive" in the form of a mask that supplies air pressure to keep the lungs inflated (CPAP or BiPAP) or invasive intubation and use of a ventilator. The cause of death in those with COPD is often the result of a complication. This includes pneumonia, respiratory failure, heart problems, lung cancer or a blood clot in the lungs (pulmonary embolism), as discussed on Merck.com.
