Chronic obstructive pulmonary disease.
Acute exacerbations of underlying COPD are a common cause of respiratory deterioration. Developments have been made in preventive measures, but admission to hospital for acute exacerbations can be expected to remain common. Several expert consensus guidelines have been published to define the appropriate management of COPD patients. These consensus guidelines generally agree, but all acknowledge a lack of large well-controlled clinical studies, especially studies focusing on the management of acute exacerbations. Consequently, many potential controversies exist about the details of managing patients with acute exacerbations. Although studies of many fundamental aspects of management are still needed, the results of controlled clinical trials are sufficient to emphasise the importance of a careful clinical assessment, supplemental oxygen, inhaled bronchodilators to partially improve airway obstruction, corticosteroids to decrease the likelihood of treatment failures and to speed recovery, antibiotics, especially in severe patients, and non-invasive positive-pressure ventilation for treatment of acute ventilatory failure in selected patients.
Pulmonary, Allergy, and Critical Care Medicine Division, University of Massachusetts Medical School, Worcester 01655, USA.
J M
JM
Madison
R S
RS
Irwin
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006760:Hospitalization; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis / Q000628:therapy*; D010102:Oxygen Inhalation Therapy; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial; D013256:Steroids
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D013256:Steroids