Acute exacerbation of chronic obstructive pulmonary disease

Acute exacerbation of chronic obstructive pulmonary disease
Other namesAcute exacerbations of chronic bronchitis (AECB)
Chest X-ray in a case of COPD exacerbation where a nasopharyngeal swab detected Haemophilus influenzae, with right-sided opacities
SpecialtyRespirology, emergency medicine

An acute exacerbation of chronic obstructive pulmonary disease, or acute exacerbations of chronic bronchitis (AECB), is a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms including shortness of breath, quantity and color of phlegm that typically lasts for several days.

It may be triggered by an infection with bacteria or viruses or by environmental pollutants. Typically, infections cause 75% or more of the exacerbations; bacteria can roughly be found in 25% of cases, viruses in another 25%, and both viruses and bacteria in another 25%. Airway inflammation is increased during the exacerbation resulting in increased hyperinflation, reduced expiratory air flow and decreased gas exchange.[1][2]

Exacerbations can be classified as mild, moderate, and severe.[3] As COPD progresses, exacerbations tend to become more frequent, the average being about three episodes per year.[4]

  1. ^ Rabe KF, Hurd S, Anzueto A, et al. (2007). "Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: GOLD Executive Summary". Am. J. Respir. Crit. Care Med. 176 (6): 532–55. doi:10.1164/rccm.200703-456SO. hdl:2066/51740. PMID 17507545. S2CID 20863981.
  2. ^ van Geffen WH, Slebos DJ, Kerstjens HA (2015). "Hyperinflation in COPD exacerbations". The Lancet Respiratory Medicine. 3 (12): 43–44. doi:10.1016/S2213-2600(15)00459-2. PMID 26679031.
  3. ^ "2 Diagnosis and Initial Assessment § Assessment of exacerbation risk". Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (PDF). Global Initiative for Chronic Obstructive Lung Disease. 2019. pp. 32–33. Retrieved 22 September 2019.
  4. ^ "Chronic Obstructive Pulmonary Disease (COPD)". Merck Sharp & Dohme Corp. Retrieved 19 May 2014.