If you have COPD, you may be wondering about COPD exacerbation -- and that's a good thing. Because of the seriousness of an exacerbation, it's important for you to know how they develop and what you can do about them.
COPD Exacerbation: Defined
In its simplest terms, an exacerbation is a worsening of symptoms. In more in-depth terms, a COPD exacerbation can be defined as “an event in the natural course of the disease characterized by a change in the patient's baseline dyspnea, cough, and/or sputum, that is beyond normal day-to-day variations, is acute in onset and may warrant a change in medication in a patient with underlying COPD,” according to the Global Initiative for Obstructive Lung Disease (GOLD).
Causes of COPD Exacerbation: Infection, Air Pollution
The top two causes of an exacerbation are infection of the airways or lungs and air pollution. In one-third of all COPD exacerbation cases, however, the cause cannot be identified.
Studies have found that smoking, lack of a pulmonary rehabilitation program, improper use of an inhaler and poor adherence to a drug therapy program are all associated with more frequent episodes of COPD exacerbation. Therefore, it is important that if you have been prescribed a treatment regimen for your COPD, you stick to the program and follow your doctor’s orders.
Signs and Symptoms of a COPD Exacerbation
The main symptom of an acute exacerbation of COPD is increased breathlessness which is often accompanied by the following:
- Increased cough and sputum production
- Change in the color and/or thickness of the sputum
- Wheezing
- Chest tightness
- Fever
Treatment of COPD Exacerbation
Often, either a hospital stay or a home-care nurse are necessary for managing an exacerbation. According to GOLD, nurse-administered home care can be a practical yet effective alternative to hospital care in certain patients with COPD exacerbation. The exact criteria used to determine who would benefit most from this approach, however, is uncertain and varies according to health care setting.
If your exacerbation of COPD cannot be managed safely at home, you will be admitted to the hospital. Once there, your treatment, as determined by your health care provider, may include the following:
- Oxygen therapy
- Glucocorticosteroids (oral, IV and/or inhaled medications that treat inflammation)
- Antibiotics (if an underlying bacterial infection exists)
- Bronchodilators
- Respiratory stimulants
- Ventilatory support - non-invasive (by mask) or invasive (by means of a tube inserted into your lungs through your mouth)
Prevention of COPD Exacerbation
Preventative strategies that may help patients with COPD prevent acute exacerbation include:
- Pneumonia and annual flu vaccine (a flu shot can decrease serious illness and death by as much as 50% for patients with COPD).
- Handwashing
- Balanced diet, sufficient amount of exercise/activity and adequate sleep
- Avoiding exposure to environmental irritants such as air pollution (pay attention to air quality alerts), extreme temperatures and cigarette smoke (including secondhand smoke).
- Avoid crowds, especially during cold and flu season
One Final Word
COPD exacerbations are debilitating, in and of themselves. The toll they take on your body can lead to disability and even death. Paying attention to your body, taking better care of yourself and taking steps towards prevention may ultimately help you to avoid a COPD exacerbation.
For further information about COPD exacerbation, be sure to talk with your primary care provider.
Sources:
Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2006. Available from:
http://www.goldcopd.org.
Gorski, Lisa MS, RN, CS, CRNI; “COPD Exacerbation: Prevention and Home Management Protocol”. Oasis Answers Inc. http://www.qualidigm.org/uploadedFiles/Professionals/Setting/HomeHealth/Best%20Practice%20Tools%20-%20Emergent%20Care%20-%20Qualidigm%2005.24.07.pdf
