Chronic Obstructive Pulmonary Disease (COPD) is a constant obstruction of the airways that often occurs with emphysema or chronic bronchitis, according to the Merck Manuals Online Medical Library. Cigarette smoking seems to be the main cause, but many patients with COPD have never smoked. In those cases, it may be caused by other air irritants or secondhand smoke. Patients are advised to quit smoking and to also stay away from irritants such as secondhand smoke and air pollution. People with COPD who continue to smoke will usually have symptoms that worsen. People in the advanced stages of COPD need constant medical care and help with activities of daily living. Death may result from respiratory failure, lung cancer, heart failure, pneumonia or pulmonary embolism, a blockage of the arteries leading to the lungs.
Airflow Decline
End stage COPD conditions occur when the patient's airflow reaches its most severe limitation, according to a review published in the European Respiratory Journal in 2007 by researchers at the University Hospital Pisa, Italy and the University of Toronto, Canada. The patients will reach a point that is described as the lowest health-related quality of life. They are often incapable of engaging in social, professional and leisure activities. Exercise becomes nearly impossible, and it is marked by extreme fatigue. In their final stages, they often have frequent respiratory difficulties that result in hospitalization. Oxygen therapy is often used at this time.
Secondary Problems
Severe secondary problems may result, which can include muscle and psychological dysfunction. Nutritional depletion is a common problem because of an imbalance in the body between low energy intake and high energy needs. The constant lack of energy affects all activities, including eating. Rehabilitation therapy has been shown to be effective at helping to prolong life and increase the quality of life even for the most severe patients.
Heart
COPD eventually puts pressure on the heart, causing further complications in the end stage. The disease makes the heart work harder and harder, resulting in the right ventricle becoming enlarged, the walls of the heart thickening and the chamber eventually losing its ability to work efficiently, according to pulmonologychannel.com, a website focusing on pulmonary disorders.
Breathing
Shortness of breath, cough and sputum production increase lead to bronchial infections. These symptoms increase as the disease progresses. The symptoms are often acute difficulties that are resolved with oxygen therapy in the earlier stages. The patients are often able to go through the therapy and continue breathing on their own. But as the disease progresses, the ability to regain their strength to breath on their own diminishes.
Lung Function
In the final stage, patients have a slow decline in lung function that causes rising levels of carbon dioxide in the blood. This can create a narcotic effect in the body. The patient may slowly lose consciousness and stop breathing. Respiratory failure can even occur during acute exacerbations, such as coughing or wheezing, to a patient with end-stage COPD.
