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Alternative Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Moving Cupping Along Meridians
Published on: September 27, 2024
Management of COPD exacerbations
1University of Wisconsin School of Medicine and Public Health, 100 N. Nine Mound Rd., Verona, WI 53593, USA. ann.evensen@uwmf.wisc.edu
American Family Physician
|March 2, 2010
Summary
Managing chronic obstructive pulmonary disease exacerbations involves increasing bronchodilator dosage, using oral corticosteroids for purulent sputum, and considering antibiotics to reduce treatment failure and mortality in severe cases.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
Background:
- Exacerbations of chronic obstructive pulmonary disease (COPD) are a major cause of mortality.
- Randomized controlled trials (RCTs) have confirmed the efficacy of various interventions for COPD exacerbations.
Purpose of the Study:
- To outline evidence-based management strategies for COPD exacerbations.
- To guide clinical decision-making for both outpatient and inpatient settings.
Main Methods:
- Review of randomized controlled trials and clinical guidelines.
- Synthesis of evidence for pharmacological and non-pharmacological interventions.
Main Results:
- Outpatient management: Increase inhaled short-acting bronchodilator dosage; consider ipratropium/albuterol combination for dyspnea.
- Oral corticosteroids are beneficial, particularly with purulent sputum.
- Antibiotics reduce treatment failure and mortality in moderately to severely ill patients, especially those with purulent sputum or inadequate response to other treatments.
- Inpatient management: Regular bronchodilators, oxygen, antibiotics, and systemic corticosteroids.
- Noninvasive or invasive ventilation for worsening acidosis or hypoxemia.
Conclusions:
- Prompt and appropriate management of COPD exacerbations can reduce mortality and treatment failure.
- Treatment decisions should be guided by symptom severity, sputum characteristics, and patient history.
- A stepwise approach incorporating bronchodilators, corticosteroids, and antibiotics is recommended.
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