Chronic obstructive pulmonary disease (COPD) management involves treatment of chronic stable disease and treatment of exacerbations.Treatment of acute exacerbations involvesOxygen supplementationBronchodilatorsCorticosteroidsAntibioticsSometimes ventilatory assistance with noninvasive ventilation or intubation and ventilationThe immediate objectives are to ensure adequate oxygenation and near-normal blood pH, reverse airway obstruction, and treat any cause.The cause of an acute exacerbation is often unknown, although most acute exacerbations result from bacterial or viral infections. Smoking, irritative inhalational exposure, and high levels of air pollution also contribute. Patients with mild exacerbations and adequate home support can often be treated as outpatients. Older, frail patients and patients with comorbidities, a history of respiratory failure, or acute changes in blood gas measurements are admitted to the hospital for observation and treatment. Patients with life-threateni...
