Exacerbation of Chronic Obstructive Pulmonary Disease

Author: Katie Manning / Editor: Jason Kendall / Reviewer: Grace McKay, Jon Bailey /  Codes: A2 / Published: 14/11/2022

This session will cover how to diagnose, assess and manage a patient with chronic obstructive pulmonary disease (COPD).

After completing this session you will be able to:

  • Specify the pathophysiology of COPD
  • State how a diagnosis of COPD is made
  • Assess a patient with COPD presenting to the emergency department with increased breathlessness
  • Recall how to safely manage a patient with an exacerbation of COPD in the emergency department
  • List the factors which may determine whether the patient requires admission or may be safely discharged home
  • Acute exacerbation of COPD
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References:

  1. British Thoracic Society. The burden of lung disease: a statistical report from the British Thoracic Society. 2nd edn. London: British Thoracic Society, 2006.
  2. Stang P, Lydick E, et al. The prevalence of COPD: using smoking rates to estimate disease frequency in the general population. Chest. 2000 May;117(5 Suppl 2):354S-9S.
  3. British Lung Foundation. Lost in translation: bridging the communication gap in COPD. London. British Lung Foundation: 2006.
  4. National Institute for Health and Clinical Excellence. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline [NG115]. 2018.
  5. Sapey E, Stockley RA. COPD exacerbations 2: Aetiology. Thorax 2006;61:250-258.
  6. Rennard S. Chronic obstructive pulmonary disease: definition, clinical manifestations, diagnosis and staging. In: UpToDate, Stoller JK (Ed), UpToDate, Waltham, MA, 2014.
  7. Wedzicha JA. Exacerbations: etiology and pathophysiologic mechanisms. Chest. 2002 May;121(5 Suppl):136S-141S.
  8. Donaldson GC, Wedzicha JA. COPD exacerbations .1: Epidemiology. Thorax. 2006 Feb;61(2):164-8.
  9. Rodrguez-Roisin R. COPD exacerbations.5: management. Thorax. 2006 Jun;61(6):535-44.
  10. Royal College of Physicians, British Thoracic Society, Intensive Care Society. Chronic obstructive pulmonary disease: non-invasive ventilation with biphasic positive airways pressure in the management of patients with acute type 2 respiratory failure. Concise Guidance to Good Practice Series, No 11. London, RCP, 2008.
  11. Lightowler JV, Wedzicha JA, Elliott MW, Ram FS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ. 2003 Jan 25;326(7382):185.
  12. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2022.
  13. Esteban A, Anzueto A, Frutos F, Ala I, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA. 2002 Jan 16;287(3):345-55.
  14. Soler-Catalua JJ, Martnez-Garca MA, et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005 Nov;60(11):925-31.
  15. Roberts CM, Lowe D, Bucknall CE, et al. Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease. Thorax. 2002 Feb;57(2):137-41.

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