1.

Pink Pufffer

A "pink puffer" is a person in which emphysema is the primary underlying respiratory problem.
Emphysema is caused by the destruction of the airways distal to the bronchiole. It involves the
gradual destruction of the pulmonary capillary bed the decreased inability to oxygenate the blood.
The body then has to compensate with a lower cardiac output and hyperventilation. Eventually,
because of the low cardiac output, people afflicted with this disease develop muscle wasting and
weight loss. They develop a reddish complexion and a "puffing" appearance when breathing
hence "pink puffer". Almost two thirds of men in the United States and one fourth of women have
emphysema at death. In general, COPD is the fourth leading cause of death in the United States.
Although this sounds extreme, out of the two types "pink puffer" or "blue bloater", a "pink puffer"
has a better overall prognosis if treatment is sought early.

2. Blue Bloater

A "blue bloater" is a person that actually suffers from chronic bronchitis. Chronic bronchitis is
caused by excessive mucus production with airway obstruction and notable hyperplasia of
mucus-producing glands. Unlike emphysema, the pulmonary capillary bed is undamaged.
Instead, the body responds to the increased obstruction by decreasing ventilation and increasing
cardiac output. This is a horrible mismatch within the body that results in a rapid circulation in a
poorly ventilated lung leading to hypoxemia and polycythemia. With this occurring, as well as
increased carbon dioxide retention, these people have signs of heart failure and are labeled as
"blue bloaters". The prognosis for a "blue bloater" is very poor.