title: Preventing Hospitalizations From Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
abstract: Chronic obstructive lung disease is among the leading causes of adult hospital admissions and readmissions in the United States. Preventing acute exacerbations is the primary approach in therapy. Combinations of smoking cessation, pulmonary rehabilitation, vaccinations and inhaled and oral medications may all reduce the overall risk of acute exacerbations. When prevention is unsuccessful, treatment of exacerbations often does not require hospitalization but can be safely executed in the outpatient setting. In the patient who does not require mechanical ventilation or who manifests respiratory acidosis, oxygen supplementation, frequent short-acting inhaled bronchodilators, oral corticosteroids and often antibiotics can abort the decompensation and sometimes return the patient to his or her pre-attack baseline lung function. Several models exist for delivering this care in the ambulatory setting. Follow-up care after an exacerbation has resolved is important, though there are few hard data suggesting which approach is best in this setting.
authors.affiliation: Department of Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee. Electronic address: burchettej@etsu.edu.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Burchette
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Mississippi School of Medicine, Jackson, Mississippi; G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, Mississippi.
authors.forename: G Douglas
authors.initials: GD
authors.lastname: Campbell
authors.affiliation: , Johnson City, Tennessee.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Geraci
mesh_terms: D006760:Hospitalization; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy
keywords: Acute; Chronic lung disease; Exacerbation; Hospital admission; Treatment