Chronic obstructive pulmonary disease exacerbation resident survival guide

Definition

COPD exacerbation commonly caused by infections, should be recognized when anyone or more of the following appears acutly in chronic COPD patient^[1]:

Worsening cough
Increasing dyspnea
Increasing in sputum production more than the baseline for chronic COPD Pts^[1]

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Differential Diagnosis

Management

COPD Exacerbation
↑cough, ↑dyspnea, ↑sputum,
↑wheezing, fever or chest tightness

Admission

Assessment :
1-O2 sat+ ABG
2-CXR
3-EKG
4-CBC

Management:
1-Inhaled bronchodilators
2-Systemic corticosteroids
3-Empirical antibiotics
4-O2 (target Sat >90%)

tahseen

Respiratory acidosis? OR
PH≤35? OR
PaCo2≥45? OR
Severe signs of dyspnea? OR
(Accessory muscles use,
paradoxical motion of abdomen,
retraction of intercostal space

No

Yes

Continue the same management

ICU Admission
NIV

Unable to tolerate NIV?
Severe hemodynamic instability?
Resp/cardiac arrest ?

Invasive mechanical ventilation

References

↑ ^1.0 ^1.1 Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P; et al. (2007). "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary". Am J Respir Crit Care Med. 176 (6): 532–55. doi:10.1164/rccm.200703-456SO. PMID 17507545.

[pmid17507545-1] 1.0 ^1.1 Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P; et al. (2007). "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary". Am J Respir Crit Care Med. 176 (6): 532–55. doi:10.1164/rccm.200703-456SO. PMID 17507545.

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