[Acute exacerbation of COPD].
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often develop into emergency situations that are associated with high morbidity and mortality. There is still a lack of a generally accepted definition for the risk stratification in AECOPD to guide an optimal diagnosis and treatment. In this article we propose a classification based on 4 degrees of severity, depending on whether outpatient treatment can be done by the patient himself or is provided by a physician and whether inpatient treatment is carried out on a general ward or on an intensive care unit. The pharmacological therapy of AECOPD relies on short acting bronchodilators, systemic corticosteroids and in case of purulent sputum on antibiotics. Longacting beta(2)-agonists or anticholinergics, theophyllin, mucolytic drugs or mechanical percussion to the chest by a physiotherapist have no proven value in the emergency treatment of AECOPD. In respiratory failure the use of oxygen therapy and non-invasive positive pressure ventilation (NIPPV) can often prevent the need for endotracheal intubation and controlled mechanical ventilation, thus preventing associated risks like the development of nosocomial pneumonia.
Lange
C G
CG
Medizinische Klinik, Forschungszentrum Borstel.
Scheuerer
B
B
Zabel
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P
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D010347:Patient Care Planning; D011175:Positive-Pressure Respiration / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D014218:Triage / Q000379:methods*
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents