Pathology: Acutedeterioration in a COPD patient’s normal ability beyond day-to-day variation.
Aetiology: URTI (Viral), LRTI (Bacterial),Non-infective (Air pollution, chronic heart failure, PE, MI)
Symptoms: Breathlessness, Cough, purulentsputum, decreased exercise tolerance
Signs: Increased respiratory rate, respiratory distress, confusion, cyanosis
Investigations: Bloods: FBC, U&E, CRP, Blood cultures, theophylline
ABG: Assess signs of respiratory failure
Chest X-Ray: Assess for source of infection
ECG:Rule out MI
SputumCulture: Aids in antibiotic selection
Treatment: Oxygen, oral steroids, antibiotics, nebulisers, Non-invasive ventilation– if ABG shows only hypoxia CPAP is used but if it shows hypoxia andhypercapnia BIPAP is required.
Complications: Decreased mobility, deterioration inlung function, mechanical ventilation, death
Prognosis: 10-20% will die within 3 months ofadmission
Figure 2.6 First LineTreatments For Acute Exacerbation of COPD
