COPD Exacerbation

Question 1

What are some causes of exacerbation?

Answer 1

• Viral (especially rhinovirus)
• Bacterial infections
• Environmental pollution

Question 2

Describe the process of exacerbation.

Answer 2

• Exposure to trigger (viral, bacterial or environmental) causes worsening airway inflammation.
• Increased inflammation = increased airway oedema and mucus hypersecretion.
  (Also have worsening: airway obstruction, dynamic hyperinflation, dyspnoea , cough).
• Increased work of breathing (WOB).

Question 3

What are the long-term effects of exacerbation?

Answer 3

• Structural lung damage (contributed by inflammatory cascade that occurs during acute exacerbation).
• Rapid decline in lung function.
• Sustained reduction in health related quality of life (QOL).
• Increased risk of future exacerbation.

Question 4

What is exacerbation of COPD?

Answer 4

An acute worsening of respiratory symptoms that result in additional therapy.

Question 5

What is mild exacerbation of COPD treated with?

Answer 5

Short Acting Bronchodilators (SABD) only.

Question 6

What is moderate exacerbation of COPD treated with?

Answer 6

• Short Acting Bronchodilators (SABDs).
• Antibiotics.

And/or
- Oral corticosteroids.

Question 7

How is severe exacerbation of COPD treated?

Answer 7

Patient requires hospitalisation or visits to the emergency department.
- Severe exacerbations may also be associated with acute respiratory failure.

Question 8

What are some symptoms of exacerbated COPD?

Answer 8

• Cold symptoms
• Cough
• Dyspnoea
• Fatigue
• Sputum colour changes
• Sputum volume changes

Question 9

What are the symptoms of non-infective exacerbation of COPD?

Answer 9

• Increased dyspnoea.
• Upper airway symptoms (e.g.:, colds and sore throats).
• Increased wheeze and chest tightness.
• Fatigue and reduced ex tolerance.
• Marked respiratory distress with dyspnoea + tachypnoea.
• Possibly acute confusion, increased cyanosis, peripheral oedema.
• Respiratory failure.

Question 10

What are the symptoms of infective exacerbation of COPD?

Answer 10

• Increased cough.
• Increased sputum purulence (change in colour and viscocity).
• Increased sputum volume.
• Pyrexia (fever).
• Increased dyspnoea.
• Upper airway symptoms (e.g.:, colds and sore throats).
• Increased wheeze and chest tightness.
• Fatigue and reduced ex tolerance.
• Marked respiratory distress with dyspnoea & tachypnoea.
• Possibly acute confusion, increased cyanosis, peripheral oedema.
• Respiratory failure.