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Treatment settings in COPD exacerbations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Depending on the severity of exacerbation and/or the severity of underlying disease, an exacerbation can be managed in 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 long-term oxygen therapy

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) 2024. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease
  2. National Institute for Health and Clinical Excellence (NICE) 2018. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care.

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