treatment settings in COPD exacerbations
Last edited 06/2018 and last reviewed 02/2021
treatment settings in COPD exacerbations
Depending on the severity of exacerbation and/or the severity of underlying disease, an exacerbation can be managed either the outpatient or inpatient setting (1).
factor |
treat at home |
treat in hospital |
able to cope at home |
yes |
no |
breathlessness |
mild |
severe |
general condition |
good |
poor/deteriorating |
level of activity |
good |
poor/confined to bed |
cyanosis |
no |
yes |
worsening peripheral oedema |
no |
yes |
level of consciousness |
normal |
impaired |
already receiving LTOT |
no |
yes |
social circumstances |
good |
living alone/not coping |
acute confusion |
no |
yes |
rapid rate of onset |
no |
yes |
significant comorbidity (particularly cardiac disease and insulin-dependent diabetes) |
no |
yes |
SaO2 < 90% |
no |
yes |
changes on chest radiograph |
no |
present |
arterial pH level |
>=7.35 |
< 7.35 |
arterial PaO2 |
>= 7 kPa |
< 7 kPa |
Reference:
- (1) Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease.
- (2) National Institute for Health and Care Excellence (NICE) 2010. Chronic obstructive pulmonary disease in over 16s: diagnosis and management