ABSTRACT
It is well recognized that the manifestations of chronic obstructive pulmonary disease (COPD) are not limited to the lungs (1), and as an exacerbation is most often defined as an interval of symptomatic deterioration (2), it is not surprising that COPD exacerbations have systemic consequences. However, the systemic consequences of exacerbations of COPD differ from the chronic systemic manifestations of COPD in both mechanism and pathophysiology and are not simply the result of an interval magnification of chronic systemic manifestations. In this chapter, we will review the mechanism and pathophysiology of the systemic consequences of COPD exacerbations, giving special attention to exacerbationspecific aspects. We will begin by describing two consequences of exacerbations, systemic inflammation and oxidative stress, both of which cause and perpetuate most of the other, more specific consequences of exacerbations. We will then describe these other consequences, highlighting their connection with systemic inflammation and oxidative stress (Fig. 1).
