Treatment of acute exacerbations

COPD management involves treatment of chronic stable disease and of exacerbations.1 Treatment of acute COPD exacerbations aims to minimize the impact of the current exacerbation and prevent the development of subsequent exacerbations.

The underlying cause of an acute exacerbation is usually unknown, although most acute exacerbations result from bacterial or viral infections.1 Smoking, irritant inhalation exposure and high levels of air pollution may also contribute.

  • Mild exacerbations can often be treated on an outpatient basis or self-managed.
  • Patients with comorbidities, a history of respiratory failure or acute changes in arterial blood gas measurements are admitted to hospital for observation and treatment.
  • Patients with life-threatening exacerbations manifested by uncorrected moderate-to-severe acute hypoxaemia, acute respiratory acidosis, new arrhythmias, or deteriorating respiratory function despite hospital treatment should be admitted to the ICU and their respiratory status monitored frequently.

Reference

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global Strategy for the Diagnosis, Management, and Prevention of COPD. 2013. www.goldcopd.org

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