[Treatment of exacerbations of chronic obstructive pulmonary disease]

Exacerbations of chronic obstructive pulmonary disease (COPD) are an important cause of both morbidity and mortality. Both infection of the tracheobronchial tree and air pollution are common causes of exacerbations. The guidelines comment that inhaled bronchodilators, theophyllines, systemic glucocorticoids, antibiotics (the latter if clinical signs of airways infection are present) are effective treatments for exacerbations of COPD. In severe exacerbations, non-invasive positive pressure ventilation is a useful adjunct to other medical therapy and improves blood gases and pH, reduces hospital-mortality, decreases the requirements for invasive mechanical ventilation and intubation and decreases the stay in hospital.