Management of chronic obstructive pulmonary disease: the Swiss guidelines. Official Guidelines of the Swiss Respiratory Society.

Chronic obstructive pulmonary disease (COPD) is defined as a disorder characterised by expiratory airflow limitation that is not fully reversible [1]. The airflow limitation is usually slowly progressive and associated with an inflammatory response of the lungs to noxious particles or gases. The airflow obstruction may be caused by structural alterations and/or functional factors. COPD, related in most cases to extensive cigarette smoking, is a leading cause of chronic morbidity and mortality among patients over 55. Over the past ten years several guidelines for the assessment and management of COPD have been published [2–5]. Our new guidelines are based on those published in 1997 [6], the GOLD report (Global initiative on chronic Obstructive Lung Disease), a collaborative project of the U.S. National Heart, Lung and Blood Institute and the World Health Organisation, and an extensive review of the pertinent literature. Following the requirements of evidence-based medicine, we used the system for assigning levels of evidence to the statements made throughout the present report (table 1) [7]. The goal of these guidelines is to advise pulmonary physicians, general practitioners and other health care workers on the early detection, diagnosis and prevention of COPD, the best symptomatic control of the disease, and the avoidance of complications and deterioration of COPD.