ABSTRACT
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are defined as events in the natural course of the disease characterised by a change in the patients baseline dyspnea, cough, and/or sputum that is beyond the normal day-to-day variations, is acute at onset, and may warrant a change in regular medication (1). Early recognition of exacerbations and prompt medical treatment improves patient’s recovery, reduces risk of hospitalization, and is associated with a better health-related quality of life (2). Pharmacological treatment consists of an “ABC approach,” an acronym for antibiotics, bronchodilators, and corticosteroids, which are the mainstay for treatment in exacerbations (3). Nonpharmacological approaches, namely oxygen therapy and ventilatory support, are also widely used, particularly in more severe presentations of the disease (4). In addition to these evidence-based medical treatments for AECOPD, other therapeutic options, such as mucus clearance strategies and respiratory stimulants have been proposed. Although these treatments have been the subject of different clinical studies during more than 30 years, solid evidence, if any, for a beneficial effect is still lacking (5). In general, these alternatives are no longer recommended in the current guidelines for treatment of AECOPD (1).
