E. Rand Sutherland, MD, MPH Journal of Allergy and Clinical Immunology

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Outpatient treatment of chronic obstructive pulmonary disease: Comparisons with asthma E. Rand Sutherland, MD, MPH Journal of Allergy and Clinical Immunology Volume 114, Issue 4, Pages 715-724 (October 2004) DOI: 10.1016/j.jaci.2004.07.044 Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 1 Natural history of COPD. The early course of disease is marked by an asymptomatic decrease in lung function. Progressive symptoms generally develop only after a significant decrease in FEV1 has occurred and worsen as lung function deteriorates further. Reprinted with permission from Sutherland ER, Cherniack RM. Management of chronic obstructive pulmonary disease. N Engl J Med 2004;350:2689-97. © 2004 Massachusetts Medical Society. All rights reserved. Journal of Allergy and Clinical Immunology 2004 114, 715-724DOI: (10.1016/j.jaci.2004.07.044) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 2 Compared with healthy individuals (upper panel, top), patients with COPD (upper panel, bottom) demonstrate hyperinflation with increased functional residual capacity (red) and total lung capacity and a decreased inspiratory capacity (blue). This increases the lung volume at which tidal ventilation occurs, places the respiratory musculature at mechanical disadvantage, and increases work of breathing. Hyperinflation worsens with exercise (bottom panel, top) but is improved by the use of inhaled bronchodilators. Journal of Allergy and Clinical Immunology 2004 114, 715-724DOI: (10.1016/j.jaci.2004.07.044) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions