Paul kleinschmidt, md, consulting staff, department of emergency medicine, womack army medical. Pink puffers are patients with copd where the pathology is widespread emphysema 1. Airflow limitation in chronic obstructive pulmonary disease copd is caused by a mixture of small airway disease and emphysema, the relative contributions of which may vary among patients. As a result of these processes, tidal breathing may take place at lung volumes as high as 1 to 2 l above normal levels. People with emphysema have been known as pink puffers or type a due to their frequent pink complexion, fast respiratory rate and pursed lips, and people with chronic bronchitis have been referred to as blue bloaters or type b due to the often bluish color of the skin and lips from low oxygen levels and their swollen ankles. The day the blue bloater met the pink puffer 20 virginia ems conference chronic obstructive pulmonary disease.
Their main symptom is breathlessness which is progressive, because their blood gases are relatively normal, their skin is of good colour and in the case of caucasians, has a pink colour. Copd a disease of airflow obstruction that is not totally reversible chronic bronchitis emphysema welcome to the city of carcinoma. Copd stands for complex obstructive pulmonary disease. Pink puffer is a generalized term for a person who is thin, breathing fast and is pink. We would like to think that dyspnea, like pain, serves as an earlywarning sign of developing disease, respiratory or cardiac. Pdf on oct 1, 2011, strambu irina and others published blue bloater, pink puffer. As charming as their names sound, pink puffer is not the furry little pink creature that you are tempted to imagine nor is the blue bloater a big and friendly blue giant.
Understanding blue bloater in context with copd a lot of people have this mentality that increasing breathlessness and coughing represents a normal part of the aging process which is. Furthermore, exacerbations seem to coincide with the rise in acute respiratory viral infections influenza, parovirus etc. Copd a chronic, progressive lung disease in which there is poor airflow in the lungs, characterized by wheezing, shortness of breath with. Download this article to citation manager,, johnson m a, woodcock a a, rehahn m, geddes d m. Do they have any resemblance to alonso quijano don quixote and his best friend mr sancho panza, respectively figure 1 3. Phenotypes of copd classified purely based on severity of emphysema. Earlier notions that blue bloaters had principally bronchitis whereas pink puffers had mainly emphysema, although widespread in relatively. In the past, the terms pink puffer and blue bloater were used to describe phenotypes of copd, implying that the disease processes extended beyond the.
Research article are pink puffers more breathless than blue bloaters. Chronic bronchitis blue bloaters o patients may be obese. Increased air space with destruction overinflation. Our class presentation for n316, wsu college of nursing. A chronic obstructive pulmonary disease which is characterized by two categories of sufferers who may either be the pink puffers or the blue bloaters. Chronic obstructive pulmonary disease copd mcmaster. Know about the signs and symptoms of chronic obstructive pulmonary disease copd, blue bloater and pink puffer do not develop until the later stages of this disease. Please practice handwashing and social distancing, and. Pdf nonemphysematous chronic obstructive pulmonary disease. Several studies have shown some link between bacterial colonization of the upper and the lower airways of patients and acute exacerbations of copd. Characterisation of phenotypes based on severity of. The blue bloated means a patient with chronic bronchitis poorly oxygenated blue and overweight.
Understanding blue bloater in context with copd by. Pdf blue bloater, pink puffer and other phenotypes of copd. Emphysema pink puffers o patients may be very thin with a barrel chest. Commonly used phenotypes are often based on pulmonary disease characteristics like the presence of. Copd chronic obstructive pulmonary disease is a class of lung ailments of which emphysema and bronchitis are two major players. Pink puffer definition of pink puffer by the free dictionary. Regardless, the pink puffer and blue bloater are useful examples of the copd clinical syndrome although one must keep in mind that an individual patient may display features of both manifestations. Are pink puffers more breathless than blue bloaters. Pdf chronic obstructive pulmonary disease copd has been classically divided into blue.
The pink puffer blue bloater distinction is vaguely defined and only applies to severe copd patients, potentially limiting its clinical utility. No, they are not names of mythical characters from a fantasy novel. Coding for the respiratory system in icd10cmpcs trisha wills, md, ccs, cpc ahimaapproved icd10cmpcs trainer. Its an old term for what we would now recognize as severe emphysema. Frequencies of the pink puffer and blue bloater subtypes of copd by severity of airflow obstruction. The concept of blue bloater copd without emphysema and therefore with normal dl co is contradicted by pathological studies and ct scans. In fact, based on clinical, pathological and radiological features, two main phenotypes have been identified. Although chronic obstructive pulmonary disease copd was arbitrarily defined in the early 1960s as a single disease characterized by chronic airflow obstruction, it has long been recognized as a heterogeneous group of related disorders. You may not embed one of our images on your web page without a link back to our site. Know the signs and symptoms pink puffers and blue bloaters copd is a chronic lung condition that makes it difficult for you to breathe. In type a patients the dominant symptom is dyspnea, while cough and hypersecretion are modest.
Nonemphysematous chronic obstructive pulmonary disease is. The blue bloaters represent those who have chronic bronchitis. To be effective as an earlywarning system, dyspnea should be absent in the absence of disease, its severity should correlate with the severity of lung function impairment, and it should be unpleasant enough to call attention to itself. Please practice handwashing and social distancing, and check out our resources for adapting to these times. Blue bloater definition of blue bloater by medical. In the patient who has significant airflow obstruction, an increased frc. Chronic obstructive pulmonary disease copd has been classically divided into blue bloaters and pink puffers.
I have heard the terms pink puffers and blue bloaters is seldom used these days. A descriptive term for a patient with copd and severe emphysema, who has a pink complexion and dyspnea. This idea derives strong support from a large european cooperative study,2 which reported that in 595 patients with chronic bronchitis and emphysemathe. Pink puffers and blue bloaters from a medical perspective. A challenge to the seven widely believed concepts of copd ncbi. If you would like a large, unwatermarked image for your web page or. A manual of standardized terminology, techniques and scoring system. The pathophysiology of blue bloaters and pink puffers. Patho final study guide type a pulmonary obstruction pink puffer. If disease is left untreated, what medical conditions can result e treatments type b copd a clinical manifestations blue bloater chronic bronchitis. No doctor is going to come out and diagnose you will get blue bloater disease. Copd is caused by inflammation and oxidative stress at the level of bronchioles and parenchyma. Chronic obstructive pulmonary disease and emphysema author.
For the best possible result, the caregiver should learn, along with the resident, about all aspects of the disease. Majohnson, aawoodcock, mrehahn, dmgeddes abstract breathlessness, disability, and exercise tolerance were assessed in 26 patients with severe chronic airflow limitation forced expiratory volume in one second fevy blue bloaters chronic bronchitis and the pink puffers emphysema. Pink puffer synonyms, pink puffer pronunciation, pink puffer translation, english dictionary definition of pink puffer. What do the terms pink puffer and blue bloater mean. They usually present with shortness of breath and pursed lip breathing. Differences between chronic bronchitis and emphysema. They are actually physical descriptions of patients who suffer from emphysema and chronic bronchitis. These are older terms the pink puffer classically described a patient with emphysema thin, pink means oxygenated. Emphysema emphysema causes dilation of airspaces by destruction of alveolar wall, leading to collapse of alveoli during expiration 6. Hypercapnia and sleep o2 desaturation in chronic obstructive. A challenge to the seven widely believed concepts of copd.
However, we invite you to revisit frank netters wonderful pink puffer and blue bloater illustrations 2, iconic images of the classical chronic obstructive pulmonary disease copd phenotypes of emphysema and chronic bronchitis. Pdf nonemphysematous chronic obstructive pulmonary. Blue puffers pink bloaters bloatware freezer best evm. In the 1960s, the terms blue bloater and pink puffer came up to describe patients with chronic bronchitis and emphysema, respectively 30, marking the very beginning of phenotyping copd. Both terms are a bit coarse and are usually tossed about in the lunch room of medical facilities. In the 1950s, dornhorst described two extreme phenotypes of patients with severe respiratory disease. There is currently no cure for copd, but treatment options such as stem cell therapy can prevent more damage and improve the patients quality of life. British medical journal volume286 15 january 1983 papersandshortreports arepinkpuffers morebreathless than bluebloaters. Pink puffer definition of pink puffer by medical dictionary. Chronic obstructive pulmonary disease copd pathway.
1454 1584 303 946 1242 721 913 328 792 491 1093 1015 846 681 373 90 290 1236 1385 1054 1113 1402 1439 1110 905 348 709 1471 1039 465 273 156 308 389 256 1033 218