Acute exacerbation of COPD: Difference between revisions

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== Diagnosis and evaluation ==
== Diagnosis and evaluation ==
The diagnosis is based on clinical symptoms. If there are severe symptoms, ABG is used to assess the level of severity.
The diagnosis is based on clinical symptoms. If there are severe symptoms, [[ABG]] is used to assess the level of severity.


== Treatment ==
== Treatment ==
In most cases, an increased dose of inhaled [[bronchodilators]] is necessary along with a short course of an oral [[corticosteroids]] like prednisolone. In Norway, ipratropium and salbutamol are usually combined 4 times daily during the exacerbation.
In most cases, an increased dose of inhaled [[bronchodilators]] is necessary along with a short course of an oral [[corticosteroids]] like prednisolone. In Norway, [[ipratropium]] and [[salbutamol]] are usually administered in a nebulizer 4 times daily for the duration of the exacerbation.


If a bacterial infection is suspected, due to infectious signs or purulent or increased volume of sputum, empiric antibiotics can be given.
If a bacterial infection is suspected, due to infectious signs or purulent or increased volume of sputum, empiric antibiotics can be given.


In cases more severe cases with [[respiratory failure]], [[O2 supplementation|O2 supplement]] or [[non-invasive ventilation]] is used. In very severe cases, [[Intensive care unit|ICU]] admission is necessary.
In cases more severe cases with [[respiratory failure]], [[O2 supplementation|O2 supplement]] or [[non-invasive ventilation]] is used. In very severe cases, [[Intensive care unit|ICU]] admission and [[invasive ventilation]] is necessary. Admission to the ICU is indicated if:
 
* If conservative therapy doesn’t work
* PaO2 < 40 mmHg
* pH < 7,25
* Haemodynamic instability
 
[[Category:Pulmonology]]
[[Category:Pulmonology]]