emDocs - December 17, 2018 - Authors: Sarah Iosifescu and Jennifer Beck-Esmay
Edited by: Alex Koyfman and Brit Long
"Key Points
- Do not assume that all patients with COPD that present with dyspnea have a clear-cut infectious or medicine non-compliant COPD exacerbation. Keep a lookout for abnormal lab results or lack of responsiveness to standard treatment in COPD exacerbations in case there are other underlying causes.
- There is mixed data on PE as a trigger for a COPD exacerbation, but the evidence so far suggests it may be real. It doesn’t mean that you need to evaluate every COPD patient for PE with CT, but it should be on your mind.
- COPD patients are more sensitive to environmental and weather triggers and are more likely to have exacerbations in cold weather and when exposed to higher air concentration of pollutants.
- Non-selective beta blockers can decrease lung function in COPD patients; use beta blockers with caution in COPD patients.
- Infections are likely the most common cause of COPD exacerbation, with bacteria the most common species. Antibiotics are associated with improved outcomes, especially in severe exacerbations."