Chronic inflammatory bronchopulmonary disorders. A physiologically oriented approach to treatment.

Abstract

The term diffuse chronic inflammatory bronchopulmonary disorders, although etiologically nonspecific, clearly identifies for many physicians a clinical syndrome of chronic and sometimes recurrent inflammation in the bronchopulmonary tree characterized symptomatically by chronic cough, expectoration, dyspnea of variable severity, and occasionally wheezing. Right heart failure (cor pulmonale) may supervene as a consequence of accompanying anatomical or functional impairment of the pulmonary vascular bed. Ultimately varying degrees of disability develop, for the most part as a result of those physiological disturbances causing dyspnea. However, disability itself leads to progressive inactivity and general physical and psychological involutional changes, producing further disability and dyspnea not directly related to pulmonary alterations per se. The ultimate anatomical results of chronic inflammation in the bronchopulmonary system may be fibrosis and emphysema. Neither of these as such can be considered remediable states. This fact often leads to an incorrect attitude of therapeutic pessimism. However, there are many aspects