Diagnostic testing

A. Pulse oximetry is an inexpensive, noninvasive procedure for assessing oxygen saturation.

B. Arterial blood gases. Both hypercarbia and hypoxemia occur when pulmonary function falls to below 25-30% of the predicted normal value.

C. Pulmonary function testing is a useful means for assessing ventilatory function. Peak-flow meters are available that can provide a quick assessment of expiratory function.

D. Chest radiography will permit identification of patients with COPD with pneumonia, pneumothorax, and decompensated CHF.

E. An ECG may be useful in patients who have a history of chest pain, syncope, and palpitations.

F. Labs: Complete blood count (CBC) is useful in patients with acute exacerbation of COPD if pneumonia is suspected. The hematocrit is frequently elevated as a result of chronic hypoxemia. A serum theophylline level should be obtained in patients who are taking theophylline. Each milligram per kilogram of theophylline raises the serum theophylline level by about 2 mcg/mL.

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