Common Etiology

• Most common: viral infection
• Bad air:
  • Smoking (RF), air pollution, occupational exposure
• Non-air (severe):
  • CongestiveHF - Heart Failure,
  • CAD,
  • !PE - Pulmonary embolism,
  • PTX - Pneumothorax

Presentation

Prognosis

Patients admitted to hospital have a 25-35% mortality within 1-year of their hospitalization

Investigation

1. Complete History → compare symptoms to baseline
2. Rule out severe causes of COPD exacerbations
3. Tests
   1. O2 Sat
   2. WOB - Work of Breathing
   3. Spirometry
   4. ABG → investigate hypercapnia
   5. Tests to rule out severe causes of COPD exacerbations
      1. e.g. CXR - Chest X ray → rule out PTX

Management

Moderate → outpatient

• Combined SABA + SAMA (M3) (Combivent®)
  • +/- Anti-Microbial (If increased sputum volume/change in purulence)

Severe → hospitalization

• Combined SABA + SAMA (M3) (Combivent®)
• Oral Corticosteroid (OCS) 40-50 mg x 5 days
  • +/- Anti-Microbial (If increased sputum volume/change in purlurence)
  • +/- Oxygen Delivery Devices, Invasive Mechanical Ventilation

On Discharge:

• Smoking cessation Therapy