Chronic Obstructive Pulmonary Disease (COPD) – Acute Exacerbation

Chronic Obstructive Pulmonary Disease (COPD) – Acute Exacerbation

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


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