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Pathology
Acute deterioration in a COPD patient’s normal ability beyond day-to-day variation.
Aetiology
URTI (Viral), LRTI (Bacterial), Non-infective (Air pollution, chronic heart failure, PE, MI)
Signs
Increased respiratory rate, respiratory distress, confusion, cyanosis
Symptoms
Breathlessness, Cough, purulent sputum, decreased exercise tolerance
Investigations
Bloods: FBC, U&E, CRP, Blood cultures, theophylline
ABG: Assess signs of respiratory failure
Chest X-Ray: Assess for source of infection
ECG: Rule out MI
Sputum Culture: Aids in antibiotic selection
Treatment
Oxygen, oral steroids, antibiotics, nebulisers, Non-invasive ventilation – if ABG shows only hypoxia CPAP is used but if it shows hypoxia and hypercapnia BIPAP is required.
Prognosis
10-20% will die within 3 months of admission
Decreased mobility, deterioration in lung function, mechanical ventilation, death
Key Facts
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Key References
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