Acute exacerbations of COPD are one of the most common reasons why people present to hospital in developed countries.

The most common bacterial organisms that cause infective exacerbations of COPD are:

• Haemophilus influenzae (most common cause)
• Streptococcus pneumoniae
• Moraxella catarrhalis

Respiratory viruses account for around 30% of exacerbations, with the human rhinovirus being the most important pathogen.

PC

• increase in dyspnoea, cough, wheeze
• there may be an increase in sputum suggestive of an infective cause
• patients may be hypoxic and in some cases have acute confusion

Management

Initial management

• Sit patient up
• 24% O2 via Venturi mask: SpO2 88-92%,
• Vary FiO2 and SpO2 target according to Arterial Blood Gas