Chapter 68 – Acute Exacerbations of COPD

Publisher Summary This chapter explains the exacerbations of chronic obstructive pulmonary disease (COPD) and its causes, mechanisms, and treatment approaches. COPD exacerbations are an important cause of the significant morbidity and mortality related to COPD. These COPD exacerbations increase with severity of the disease, and frequent exacerbations impact the patient's quality of life and activities of daily living. These exacerbations are also associated with considerable physiological deterioration and increased airway inflammatory changes caused by a variety of factors such as viruses, bacteria, and some common pollutants. Exacerbation of COPD results in an increase in airflow obstruction, which further increases the load on the respiratory muscles and increases the effort in breathing, thereby leading to respiratory failure in severe cases. Treatment approaches include the use of corticosteroids, antibiotics, inhaled bronchodilator therapy in certain cases, and ventilatory support. Increased patient education about detecting and treating exacerbations early in the natural history of COPD can be significantly beneficial. Following an exacerbation, the patient's condition should be constantly reviewed, giving attention to risk factors and compliance with therapy.