Chronic obstructive pulmonary disease (COPD) is a persistent respiratory disease that may cause long-term, progressive lung damage. Acute exacerbations are when a person’s respiratory symptoms significantly worsen.
People with
chronic obstructive pulmonary disease (COPD)
may experience episodes of severe, acute symptoms that require therapy. An acute flare-up is a sudden, short-term onset of symptoms.
These are known as exacerbations and may:
contribute to COPD progression
increase healthcare costs
lead to a change in your treatment plan and medication
cause irreversible lung damage
lower your quality of life
increase your risk of hospitalization and death
The average person with COPD experiences between
exacerbations a year. Exacerbation symptoms may take
to develop, and periods may last between 7 and 14 days. However, according to research, lung function may not fully return to pre-exacerbation levels
.
It’s estimated that more than
healthcare visits per year in the United States are due to COPD exacerbations. In 2019, according to the Centers for Disease Control and Prevention (CDC), COPD was the
cause of death.
Exacerbation symptoms may differ from typical COPD symptoms, and they’re often more severe. The most common exacerbation symptom is
, which is shortness of breath or difficulty breathing.
Other signs and symptoms may include:
breathing in a fast, shallow pattern
feeling excessively sleepy or confused
lower
than the clinical expectation
increased
production, which is often yellow, green, tan, or even blood-tinged
wheezing and chest tightness
It’s important to speak with a doctor if you recognize
or experience any of these signs or symptoms. One exacerbation may be enough to increase the frequency, duration, and severity of episodes.
Some COPD exacerbation symptoms require immediate emergency care. Examples include:
severe
blue or clammy complexion
difficulty walking
having a
catching your breath
A COPD exacerbation increases the current inflammation of your airway and lungs. This may be triggered by:
viral infections, such as those caused by human rhinoviruses, which include the
bacterial tracheobronchial infections
smoking
air pollutants and irritants, such as chemical agents, fumes, and dust
There’s currently no single test to diagnose a COPD exacerbation. A doctor will assess your symptoms to see whether they stem from a worsening
, such as pneumonia, osteoporosis, or acute cardiac failure.
Medical Research Council (mMRC) dyspnea scale
Clinical COPD Questionnaire (CCQ)
St. George’s Respiratory Questionnaire (SGRQ)
The doctor will then make a diagnosis based on the questionnaire and the symptom elimination process.
Treatments for COPD exacerbations focus on reducing the effects of the current episode and depend on whether you’re hospitalized. Exacerbations may be
mild, moderate, or severe.
Home treatments
It is estimated that
of COPD exacerbations are typically mild or moderate and can be
with medication.
A doctor may prescribe:
Antibiotics: If bacteria caused your respiratory infection, taking
may stop the infection from getting worse.
Inhalers:
, such as
(Combivent Respimat) and
(Xopenex), help open the airways to facilitate breathing.
reduce lung inflammation. Sometimes, these are combined, such as with
(Advair).
Corticosteroids: These medications are designed to help reduce lung inflammation, which leads to narrowing and swelling in the airways.
(Medrol) is one example.
Emergency treatments
Some people who experience severe COPD exacerbations may be hospitalized. This might be due to symptom severity, limited support at home, or poor response to initial treatments.
At a hospital, the doctor may provide you with
to support your breathing. The first method is through a
, which is known as noninvasive ventilation (NIV).
If your symptoms are very severe, such as involving cardiac or respiratory arrest, or you do not respond well to NIV, the doctor will likely put you on a
. If mechanical ventilation is needed, you’ll stay in the intensive care unit until your infection clears or your lungs become less inflamed.
Establishing a COPD
with a doctor is an important step to help prevent future exacerbations.
Along with taking any prescribed medication, some self-care practices include:
avoiding exposure to lung irritants, such as kerosene heaters in your home
avoiding large crowds during cold and flu season to help
drinking plenty of fluids to prevent mucus from becoming too thick
monitoring and keeping a written record of your symptoms
keeping regular appointments with a
, such as a pulmonologist
monitoring your oxygen levels with a
using a
continuous positive airway pressure (CPAP) device
to help keep your lungs open
What are the common signs of COPD exacerbation?
The most common indicator of a COPD exacerbation is dyspnea, which is shortness of breath or difficulty breathing. Other common signs are wheezing, chest tightness, and increased mucus.
What does a COPD exacerbation feel like?
A COPD exacerbation is when you experience an episode of severe, acute symptoms. You may experience chest tightness and find it very difficult to catch your breath. You may also notice that you’re breathing in a fast, shallow pattern. This might make you feel anxious or excessively tired for a prolonged period of time.
If you’re having trouble walking, feeling confused, or have clammy skin, it’s important to get medical assistance.
Can COPD exacerbation be treated?
Mild and moderate COPD exacerbations may often be treated at home, while severe episodes might require hospitalization.
At-home treatments can include medications, lifestyle and dietary adjustments, and engaging in and keeping a record of self-care activities.
Hospital treatments might include oxygen therapy, mechanical ventilation, and medications.
COPD exacerbations are very serious. They may cause permanent lung damage, lower your quality of life, and increase your risk of mortality. Having one exacerbation may also heighten the severity and frequency of future exacerbations. Prevention is very important.
If you have COPD or suspect any early signs of an exacerbation, speak with a doctor.