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This multi-authored textbook is comprised of 45 chapters divided into 10 parts and is directed at pulmonary specialists, internal medicine physicians, or general practitioners.  It seeks to provide a comprehensive knowledge base for the diagnosis and management of chronic obstructive pulmonary disease (COPD).  The final section devotes several chapters to differences in COPD management throughout the world.

   An introduction and foreword by Claude Lenfant, M.D. and Gordon Snider, M.D. give an overview of the text itself and of the disease, encompassing a review of the history of medicine of COPD, our current understanding, and some future challenges.

   Part I focuses on the diagnosis and follow-up of chronic obstructive pulmonary disease.  This section deals with detection of the disorder through physiologic and biochemical testing, examination of the COPD patient, arterial blood gas analysis, and imaging techniques.  The second half of this section pertains to provision of follow-up for the COPD patient with specific chapters regarding dyspnea, quality of life, and disability assessments.  Chapter 6, “Diagnosis, Initial Assessment, and Follow-up of COPD” does outline objectives for the clinician, with a heavy emphasis on diagnostic testing rather than therapeutic interventions.  Chapter 9, “Disability in Chronic Obstructive Pulmonary Disease” provides a useful framework for the clinician to approach judgements about impairment and disability in this disease with a focus on the British Thoracic Society guidelines.

   Parts II, III and IV are a thorough treatise on the pharmacologic management of the disease.  These chapters are naturally not comprehensive nor up-to-date given the ever-changing nature of pharmaceutical development, however they do offer an excellent foundation and background for the practicing clinician.

   Part V is devoted to associated conditions, including lung cancer, left- and right-sided heart failure, anxiety, depression, and sleep disorders. Chapters 22 and 23, which pertain to right and left heart function and dysfunction in COPD are particularly useful and complete. Additionally, the chapters on sleep-associated respiratory disorders in COPD are both informative and practical.

   Parts VI and VII discuss malnutrition management, rehabilitation, and the role of respiratory muscles training during rehabilitation. Long-term oxygen therapy, noninvasive ventilatory support, and use of tracheostomies are subsequently reviewed.

   Finally, Parts VIII, IX, and X give an overview of newer and experimental therapies for COPD management.   These sections include chapters on volume pneumectomy (“lung volume-reduction surgery), transplantation, and potential new pharmacologic approaches.  The last section, “Management of COPD through the World”, affords a comparison of similarities and differences between national guidelines, as well as perspectives on management of the disease in different continents and cultures.  The book is closed with a chapter written by Nikolai Khaltaev, M.D., Ph.D. of the World Health Organization, and presents an excellent global overview.

   The authors, authoritative in the field, give thorough and extensive reviews of the subjects at hand. Each chapter itself is generally well-referenced.  The chapters are up to date (as of 2002), given the nature and scope of this type of collective work.  There are varying levels of information, usefulness, and practical suggestions in each chapter, as expected in a text with nearly 100 contributing authors. Discussions at times may be academic rather than directly applicable to clinical practice as a “hands on” manual for the management of COPD.  Omissions include the lack of information on principles and practice of smoking cessation and the role of vaccinations in COPD management.  Overall however this is a highly readable and nearly comprehensive text on the disorder as one is likely to find.  Related readings include Comprehensive Management of Chronic Obstructive Pulmonary Disease by Bourbeau et al., (BC Decker, 2002) and Chronic Obstructive Lung Diseases (BC Decker, 2001) by Voelkel and MacNee.

Ratings (1-4 , 4 being the highest):

Organization of information:    4

Usefulness of book:     3

Suitable for intended audience:    4

Author’s objectives met:      3

Significant number of illustrations:     1

Quality of illustrations:    1

Table of Contents: 

Part I:  Diagnosis and Follow-Up

Chapter 1.     The Lung in Transition from Health to Disease

Chapter 2.     Clinical Examination in Clinical Obstructive Pulmonary Disease and Correlation with Functional Abnormalities

Chapter 3.     Technique and INterpretation of Blood Gases in Stable Chronic Obstructive Pulmonary Disease

Chapter 4.     Basic Spirometry in COPD

Chapter 5.     Imaging Techniques of the Thorax in Stable Chronic Obstructive Pulmonary Disease Patients

Chapter 6.     Diagnosis, Initial Assessment , and Follow-Up of COPD

Chapter 7.     Assessment and Management of Dyspnea in Chronic Obstructive Pulmonary Disease

Chapter 8.     The Assessment of Health-Related Quality  of Life Among Patients with Chronic Obstructive Pulmonary Disease

Chapter 9.     Disability in Chronic Obstructive Pulmonary Disease

Chapter 10.   The General Practitioner and the Chronic Obstructive Pulmonary Disease Patient

Part II:  Pathophysiological Treatments

Chapter 11.   Genetics of Chronic Obstructive Pulmonary Disease and Emphysema: Diagnostic Applications and Therapeutic Perspectives

Chapter 12.   Is There a Place or a Future for Antioxidant Therapy in COPD?

Part III:  Pharmacological Therapy

Chapter 13.   Methodology of Therapeutic Trials in COPD

Chapter 14.   Beta₂- Adrenergic Bronchodilators in the Treatment of Stable COPD

Chapter 15.   The Indications and Use of Inhaled Anticholinergic Agents in COPD Patients

Chapter 16.   Steroids in Stable COPD

Chapter 17.   Is There a Place for Vasodilators in Stable COPD?

Chapter 18.   Is There a Place for Respiratory Analeptics or Related Drugs in Stable COPD Patients?

Chapter 19.   Should Drugs Affecting Mucus Properties Be Used in COPD?

Part IV:  Treatment and Prevention of Infection

Chapter 20.   Indications for and Choice of Antibiotics in COPD

Part V:  Associated Diseases and Their Therapy

Chapter 21.   The Diagnosis and Management of Lung Cancer in COPD

Chapter 22.   The Heart in the Stable COPD Patint

Chapter 23.   COPD and the Left Heart

Chapter 24.   Anxiety and Depression in COPD

Chapter 25.   Sleep-Related Respiratory Disorders in COPD: When and How to Make the Diagnosis

Chapter 26.   Sleep-Related Respiratory Disorders in COPD:  Who and How to Treat

Part VI:  Respiratory Muscles, Nutrition and Physiotherapy

Chapter 27.   The Relevance of Respiratory Muscles in COPD Patients and How to Assess their Function

Chapter 28.   Corticosteroids and Muscle Function in Stable COPD

Chapter 29.   Pharmacotherapy and Hormone Therapy of the Respiratory Muscles in Stable COPD

Chapter 30.   Nutritional Assessment and Support of the Stable COPD Patient

Chapter 31.   Respiratory Physiotherapy in Stable COPD

Chapter 32.   Exercise in Stable COPD

Chapter 33.   Respiratory Muscle Training in Chronic Obstructive Pulmonary Disease

Part VII:  Instrumental Treatments

Chapter 34.   Long-Term Oxygen Therapy in Stable COPD

Chapter 35.   Domiciliary Noninvasive Ventilatory Support

Chapter 36.   The Indications for the Management of Tracheostomy in COPD

Part VIII:  Surgery

Chapter 37.   Management of the COPD Patient Undergoing Surgery

Chapter 38.   Lung Volume Reduction Surgery and Chronic Obstructive Pulmonary Disease

Chapter 39.   Lung Transplantation and COPD

Part IX:  Perspectives

Chapter 40.   New Treatments for COPD

Part X:  Management of COPD Through the World

Chapter 41.   Critical Comparison of Guidelines

Chapter 42.   Epidemiology and Management of COPD in Russia

Chapter 43.   Epidemiology and Management of Stable COPD in Africa

Chapter 44.   Chronic Obstructive Pulmonary Disease in Latin America

Chapter 45.   The Point of View of the WHO on Chronic Obstructive Pulmonary Disease