[Acute exacerbations of chronic obstructive pulmonary disease - review]

Chronic obstructive pulmonary disease is common and is associated with high morbidity and mortality. It leads to huge costs in the health care system. One of the reasons is acute exacerbations that lead to hospital admissions, increased medication use and other costly operations. They can also lead to death. In this review we will discuss the definition of acute exacerbation, causes and differential diagnosis. Treatment will be discussed and ways to avoid repeated exacerbations. Among ways to prevent acute exacerbations is drug treatment such as inhaled long-acting bronchodilators, inhaled corticosteroids and combination treatment. In selected cases antibiotics and antioxidants can be helpful. Influenza and pneumococcal vaccinations are important in addition to pulmonary rehabilitation. It is important to evaluate the role of co-morbidities and treat those diseases also. Examples of comorbidites are coronary artery disease and heart failure but also anxiety and depression.