Management of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in Hospitalized Patients From Admission to Discharge: A Comprehensive Review of Therapeutic Interventions

Abstract

Chronic obstructive pulmonary disease (COPD) is a common and debilitating condition that often necessitates hospitalization for exacerbations. Since COPD exacerbations can cause significant morbidity and mortality, managing them is crucial for patient care. Effective management of COPD exacerbations is essential to prevent complications, as COPD exacerbations are associated with increased healthcare costs and decreased quality of life. This review aims to comprehensively discuss the management of COPD exacerbations, covering various pharmacologic and non-pharmacologic strategies. These include inhaled bronchodilators, systemic steroids, antibiotics, invasive and non-invasive ventilation, oxygen therapy, smoking cessation, immunization with pneumococcal vaccine, inhalers at discharge, pulmonary rehabilitation, long-term oxygen therapy (LTOT), ambulatory oxygen therapy, short-burst oxygen therapy, extracorporeal membrane oxygenation (ECMO), lung volume reduction surgery (LVRS), endobronchial procedures, and lung transplant. It is drawn upon various sources, including clinical studies, systemic reviews, and observational studies, to provide a comprehensive overview of current practices and identify areas for future research and innovation in managing COPD exacerbations. Addressing these areas of interest can improve patient outcomes and quality of life.

Incidence and Management of Skin Lesions and Minor Wounds in Chronic Obstructive Pulmonary Disease Patients undergoing Advanced Bronchodilator Therapy

“…A significant enhancement in the moisture content of the epidermis and a decrease in the duration of wound healing were observed in the cohort that underwent combined therapy, as opposed to those who received triple inhalation therapy exclusively 14 . This indicates that the combined therapy may have protective effect on skin health, potentially as a result of bronchodilators' ability to increase oxygenation in peripheral tissues 15‐17 …”

“… 14 This indicates that the combined therapy may have protective effect on skin health, potentially as a result of bronchodilators' ability to increase oxygenation in peripheral tissues. 15 , 16 , 17 …”

Management of Refractory Chronic Obstructive Pulmonary Disease: A Review

“…Typical symptoms of COPD include dyspnea, wheezing, chest tightness, fatigue, and cough, which could be productive and may experience acute events or increased respiratory symptoms called exacerbations [12]. Standard interventions like bronchodilator therapy, vaccinations, smoking cessation, and pulmonary rehabilitation can control the majority of patients with less severe COPD [13,14]. There is no universal definition of refractory COPD.…”

Comparing Glycopyrronium/Formoterol Combination Therapy With Monotherapy in Moderate-to-Severe Chronic Obstructive Pulmonary Disease (COPD): A Narrative Review

“…Chronic obstructive pulmonary disease (COPD) is a respiratory condition characterized by airflow limitation, typically associated with chronic bronchitis and emphysema [1]. It is a major cause of morbidity and mortality worldwide, with a significant impact on the quality of life of affected individuals.…”

“…While bronchodilators, such as long-acting muscarinic antagonists (LAMAs) and long-acting beta-2 agonists (LABAs), are mainstays of COPD treatment, combining these agents can offer synergistic effects by targeting different pathways involved in bronchoconstriction and airflow limitation. The rationale for combination therapy lies in the potential for enhanced bronchodilation, improved symptom control, and reduced exacerbation risk compared to monotherapy [1].…”