[Care of patients with exacerbation of chronic obstructive lung disease]

Exacerbations of chronic obstructive pulmonary disease are a common cause of hospital admission. They have a profound effect on the quality of life, disease progression and healthcare costs. The central event is amplified inflammation with many biomarkers who are not in clinical use. Severe dyspnea and large volume of purulent sputum are typical clinical presentation of exacerbation due to viral or bacterial infections. Bronchodilators and corticosteroids are the mainstay of pharmacologic therapy of exacerbation, antibiotics are useful in the presence of purulent sputum and other signs of respiratory infection. Acute respiratory failure in patients with exacerbation of COPD demand controlled oxygen therapy and noninvasive ventilation or conventional mechanical ventilation. Important advances have been made in understanding etiology and pathogenesis of inflammation in exacerbation of COPD. There is a proposal for approach to such patients in emergency departement and a guidelines for pharmacologic therapy and oxygen therapy.