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.
Questa linea guida cita 2 dei 35 studi fondamentali del nostro registro di Pneumologia.
How long a steroid course1
- 2013REDUCEPneumo · BPCO · Durata degli steroidiIn 314 pazienti con riacutizzazione di BPCO, 5 giorni di prednisone 40 mg non era inferiore riguardo alla ri-riacutizzazione entro 180 giorni rispetto al trattamento di 14 giorni.
Non-invasive ventilation in respiratory failure1
- 1995Brochard NIVPneumo · BPCO · NIVIn 85 pazienti con insufficienza respiratoria ipercapnica acuta da BPCO, la NIV con maschera facciale ha ridotto le intubazioni e la mortalità ospedaliera rispetto alla terapia standard.