Treatment of acute copd exacerbation

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Chronic obstructive pulmonary disease (COPD) management involves treatment of chronic stable disease and treatment of exacerbations.
Treatment of acute exacerbations involves

Oxygen supplementation
Bronchodilators
Corticosteroids
Antibiotics
Sometimes ventilatory assistance with noninvasive ventilation or intubation and ventilation

The immediate objectives are to ensure adequate oxygenation and near-normal blood pH, reverse airway obstruction, and treat any cause.
The cause of an acute exacerbation is usually unknown, although some acute exacerbations result from bacterial or viral infections. Smoking, irritative inhalational exposure, and high levels of air pollution also contribute.
Mild exacerbations often can be treated on an outpatient basis in patients with adequate home support. Older, frail patients and patients with comorbidities, a history of respiratory failure, or acute changes in blood gas measurements are admitted to the hospital for observation and treatment. Patients with life-threatening exacerbations manifested by uncorrected moderate to severe acute hypoxemia, acute respiratory acidosis, new arrhythmias, or deteriorating respiratory function despite hospital treatment should be admitted to an intensive care unit and their respiratory status monitored frequently.