ABSTRACT

Management of COPD Exacerbations The management of respiratory decompensation in patients with COPD must be based on the underlying cause. Obviously, specific therapy is indicated in patients with pneumonia, pneumothorax, PE, and LV failure; these disorders are not discussed further. In most cases, however, no definite precipitating factor can be identified, and patients are typically treated with bronchodilator and anti-inflammatory medications. Patients with mild exacerbations can usually be managed with outpatient therapy. Those with more severe respiratory im­ pairment often require hospital admission for intensive pharmacotherapy, oxygen adminis­ tration, and, when necessary, mechanical ventilation. Indications for hospitalization and intensive care unit admission are listed in Tables 7 and 8, respectively.