Management of acute exacerbations in chronic obstructive pulmonary disease.
Curr Opin Pulm Med
; 6(2): 122-6, 2000 Mar.
Article
en En
| MEDLINE
| ID: mdl-10741771
ABSTRACT
An acute exacerbation of chronic obstructive pulmonary disease (COPD) is characterized by an acute worsening of symptoms accompanied by lung infection. In severe cases, an acute exacerbation may cause respiratory failure and death. Successful management of acute exacerbation of COPD in either the inpatient or outpatient setting requires attention to a number of key issues. In this review, issues regarding the management of acute exacerbations of COPD are discussed. An inhaled beta-2 agonist along with the inhaled anticholinergic bronchodilator are recommended. Antibiotic therapy has been demonstrated to improve clinical recovery and physical outcomes. It should be directed against the most commonly occurring pathogens and, in more severe cases, coverage against Gram-negative bacteria is considered. Short course of systemic steroids does provide benefit in hospitalized patients. Supplemental oxygen is appropriate for all patients with hypoxemia. Ventilatory support treatment may be necessary, noninvasive ventilatory assistance being preferable early in the course of the acute episode. In a high number of cases, endotracheal intubation may be avoided. Promoting smoking cessation and the use of influenzae and pneumococcal vaccination may help decrease frequency of episodes of these exacerbations.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Broncodilatadores
/
Agonistas Adrenérgicos beta
/
Antagonistas Colinérgicos
/
Enfermedades Pulmonares Obstructivas
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Curr Opin Pulm Med
Año:
2000
Tipo del documento:
Article
País de afiliación:
Estados Unidos