Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline
Six questions about the exacerbation itself, answered where the evidence allowed and left open where it did not. Oral corticosteroids are suggested over intravenous in the patient who can swallow, and the course is short: five days, not the two weeks that convention had settled on. Antibiotics are suggested in the exacerbation that needs hospital admission. Non-invasive ventilation is recommended for the patient whose exacerbation brings acidotic hypercapnic respiratory failure, which is the one recommendation here that changes who survives. Home-based management and a pulmonary rehabilitation programme begun within three weeks of discharge are both suggested. The register's two trials behind these recommendations are below.
Esta guía cita 2 de los 35 ensayos de referencia de nuestro registro de Neumología.
How long a steroid course1
- 2013REDUCENeumología · EPOC · Duración del tratamiento con esteroidesEn 314 pacientes con exacerbación de EPOC, 5 días de prednisona 40 mg fue no inferior respecto a la reexacerbación a los 180 días en comparación con 14 días de tratamiento.
Non-invasive ventilation in respiratory failure1
- 1995Brochard NIVNeumología · EPOC · VNIEn 85 pacientes con insuficiencia respiratoria hipercápnica aguda por EPOC, la VNI con mascarilla facial redujo la intubación y la mortalidad hospitalaria en comparación con el tratamiento estándar.