What does the final stage look like?
In addition to the typical symptoms of COPD – chronic coughing and increased purulent sputum and difficulty breathing – the final stage of COPD leads to chronic respiratory insufficiency. Due to the constant over-inflation of the lungs and increasing disruption of the gas exchange, the patient is no longer supplied with sufficient oxygen, which is indicated by a low oxygen pressure in the blood. In addition, patients are no longer able to breathe out the carbon dioxide produced in the body properly.
This manifests itself by severe shortness of breath at rest, reduced blood circulation and can also lead to restlessness and confusion. The chronic respiratory insufficiency can be treated by long-term oxygen therapy, home respiration, lung volume-reducing procedures or, in extreme cases, lung transplantation. A further symptom of a permanent oxygen deficiency is cyanosis (bluish discoloration due to reduced blood flow) of the lips and fingernails.
Patients in late stages often have a so-called barrel thorax, a chest that is visibly inflated from the outside, due to the constant over-inflation and weakened breathing muscles. Since COPD is associated with a high level of physical exertion and the entire organism is weakened as a result, patients in the final stages often also suffer from associated secondary diseases. Examples include diabetes, osteoporosis, severe underweight, cardiovascular weakness and depression. Infections occur more frequently in the final stage and lead to acute attacks, the exacerbations. This can be life-threatening for the patient.
How does COPD progress?
COPD is a chronic obstructive airway disease, which often begins insidiously and is not even perceived as such at first and develops over the years. The airways are only slightly narrowed at the beginning, so the continuous loss of lung function is hardly noticed at first. In the course of time, the coughing with purulent sputum increases steadily and causes breathing difficulties, first under stress, later also at rest.
The chronic inflammatory process causes constant changes in the mucous membranes, increasing narrowing of the small airways (bronchi), over-inflation of the pulmonary alveoli and thus the formation of so-called emphysema, an excessive accumulation of air.However, the individual courses of the disease are different, as they depend on the age of the patient and are also often characterized by secondary and concomitant diseases. The clinical picture of COPD often leads to a spiral of inactivity. COPD leads to shortness of breath, so patients move less, which leads to a lack of fitness and increases the shortness of breath.
This spiral is steadily increasing and is also accompanied by depressive moods, as a result of which patients feel less confident. To break this vicious circle, medical treatment and appropriate additional support is urgently needed. Inactivity spiral: shortness of breath → less exercise → depression (less self-confidence) → less exercise
