COPD exacerbation involves the flare up or worsening of COPD. COPD exacerbation is typically due to a lung infection, but in some instances it’s not known why a patient will suffer a worsening of symptoms. Typically exacerbation is treated with a cycle of antibiotics, even if the cause of the exacerbation is unknown. Some physicians believe that early treatment with a cycle of antibiotics can prevent the process from getting worse. Whatever the cause of the exacerbation, a person should contact their physician if their symptoms worsen.
Treatment Options and Oxygen Therapy
The symptoms or signs of exacerbation are similar to those of pneumonia or an infection. The color and amount of sputum is also important to note. A change in the color of sputum from clear to deep green or yellow, red or brown, or the amount of sputum, and an increase in shortness of breath, are typical symptoms and signs of exacerbation.
If a person is hospitalized for complications of COPD, they will probably be prescribed antibiotics, oxygen therapy and have chest x-rays taken, in addition to several types of blood tests. The tests that are ordered will help to guide the physician on how to best treat the patient. At times, despite all treatments, the lungs will be unable to appropriately take in O2. In that event, a person may require a ventilator, in order to help them breathe. Once a patient is on a ventilator it can be a long and slow process to remove them from it. In some instances, when an infection begins to go away, a patient can be taken off of a ventilator in less than a week. At other times, it can take several weeks or even months for a patient’s lungs to regain strength. There can also be cases when the patient is unable to breathe again without the use of a ventilator. Continuous use of a ventilator for an indefinite amount of time is referred to as ventilator dependency. A patient, their family and their physician should always discuss what they would like to have done if they are ever in a position where they will require a ventilator permanently or temporarily. The preferences and views of a patient when it comes to the choices for ventilator use, or other types of therapy can be outlined in a document, referred to as an advanced directive.
While a patient may experience more shortness of breath than usual when suffering from an exacerbation, pneumonia or bronchitis, these conditions will not necessarily require a person to be hospitalized. The patient’s physician will determine whether they need to be admitted based on their medical history and symptoms.
Acute exacerbations of COPD can be a major problem for some people who are trying to cope with this disease. Attacks or exacerbations usually occur more often in people who are suffering from stage three or four COPD, and these disease flare ups can either cause or signal a more rapid progression of chronic obstructive pulmonary disease, over time.
An exacerbation is hard to define: the only widely accepted definition is a persistent and significant worsening of breathing in a patient with COPD, requiring a reevaluation of medications- usually including antibiotics and systemic corticosteroids, in order to help the patient to recover. While most exacerbations will not require the patient to be hospitalized, it can take days or weeks of coughing, shortness of breath, and a decline in the quality of life. A patient’s pre-exacerbation exercise ability and lung function often will not fully return after recovery from an infection or attack.
Because exacerbations cause a worsening of the disease and can significantly shorten a patient’s life expectancy, preventing these attacks from occurring is a major goal of physicians.
Corticosteroids are typically prescribed as the first line of therapy, when treating an attack, however, it’s not clear whether this type of medication therapy is effective in preventing COPD exacerbations. This type of medication therapy tends to be more effective in patients who are in stage one or stage two of COPD.
Signs, Symptoms and Causes of an Attack
The symptoms of an attack will often involve the worsening of COPD symptoms. These symptoms will include chest tightness, shortness of breath, especially during exercise or other types of physical activities, wheezing, increase fatigue, lack of energy, significant weight loss, reoccurring respiratory infections and blueness of fingernail beds or lips.
How the Lungs are effected by COPD
The main cause of this disease is smoking, although only about twenty percent of chronic smokers will develop this disease. Some tobacco smokers will be diagnosed with less common lung conditions, which are initially misdiagnosed as COPD, until a more thorough evaluation is performed.
This disease can also often occur in women who are exposed to fumes from burning fuel for heating and cooking, in poorly ventilated homes.
Air will travel down the trachea and into the lungs through two large tubes known as the bronchi. Inside the lungs the bronchi divides several times into several smaller tubes known as bronchioles, which end in small clusters of air sacs. These air sacs have paper thin walls that are full of tiny capillaries. The oxygen that’s contained in the air a person inhales will pass into these capillaries and then enter the bloodstream. At the same time, a gas known as carbon dioxide is also inhaled.
A person’s lungs will rely on the elasticity of the large bronchial tubes, in addition to air sacs, to expel air out of the body. This disease will cause the bronchial tubes to lose their elasticity and cause the air sacs to partially collapse, which will leave some air trapped in the lungs when a person exhales.
Some causes of airway obstruction include the lung disease known as emphysema. This disease will cause the destruction of elastic fibers and fragile walls of the alveoli. The small airways will collapse when a person exhales, which in turn will impair the airflow out of the lungs.
Chronic bronchitis involves the inflammation of the lungs and bronchial tubes, which causes the lungs to produce more mucus. The mucus will also further narrow and block the bronchial tubes. A person will also develop a chronic cough trying to clear out the airways.