Managing COPD, part 2: Acute exacerbations

Research output: Contribution to journalArticle

Abstract

The standard therapies for acute exacerbations of chronic obstructive pulmonary disease include short-acting bronchodilators, supplemental oxygen, and systemic corticosteroids. For most patients, an oxygen saturation goal of 90% or greater is appropriate. Bilevel positive airway pressure (BiPAP) is usually beneficial in patients with progressive respiratory acidosis, impending respiratory failure, or markedly increased work of breathing. However, BiPAP should not be used in patients with respiratory failure associated with severe pneumonia, acute respiratory distress syndrome, or sepsis. Systemic corticosteroids are appropriate for moderate to severe acute exacerbations; many experts recommend relatively low doses of prednisone (30 to 40 mg) for 7 to 14 days. Antibiotic therapy is controversial, but evidence supports the use of antibiotics in patients who have at least 2 of the following symptoms: increased dyspnea, increased sputum production, and sputum purulence.

Original languageEnglish (US)
Pages (from-to)335-341
Number of pages7
JournalJournal of Respiratory Diseases
Volume26
Issue number8
StatePublished - Aug 2005

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Chronic Obstructive Pulmonary Disease
Sputum
Respiratory Insufficiency
Adrenal Cortex Hormones
Work of Breathing
Oxygen
Anti-Bacterial Agents
Respiratory Acidosis
Pressure
Bronchodilator Agents
Adult Respiratory Distress Syndrome
Prednisone
Dyspnea
Sepsis
Pneumonia
Therapeutics

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Managing COPD, part 2 : Acute exacerbations. / Adams, Sandra G.

In: Journal of Respiratory Diseases, Vol. 26, No. 8, 08.2005, p. 335-341.

Research output: Contribution to journalArticle

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