Exacerbation of COPD: Why Do Exacerbations of COPD Attract Attention? Are There Any Preventive Methods?

Abstract

Chronic obstructive pulmonary disease (COPD) exacerbation is defined as an acute event characterized by a worsening of the patient’s respiratory symptoms that is beyond the normal day-to-day variations and leads to a change in medication. Since exacerbations are associated with deterioration of quality of life, accelerated rate of decline of lung function, increased mortality, and high socioeconomic costs, the prevention of exacerbations is one of the main targets of maintenance therapy for COPD. Exacerbations are largely a feature of moderate-to-severe COPD, with some COPD patients predisposed to frequent exacerbation phenotype, whose pulmonary functions show rapid deterioration. The most commonly used medications for COPD exacerbations are antibiotics, bronchodilators, and corticosteroids (ABC approach), while appropriate oxygen therapy and ventilator support are widely accepted as two major non-pharmacologic treatments. COPD exacerbations can often be prevented. Conforming to the management strategy for stable COPD patients is essential. Many types of pharmacologic and non-pharmacologic interventions such as long-acting inhaled bronchodilators and corticosteroids, phosphodiesterase inhibitor, and pulmonary rehabilitation program for posthospitalization periods are reported to be effective. Further understanding into the nature of exacerbations, invention of new effective interventions, and investigations to identify suitable combinations for interventions are required to develop more rational, preventive regimes for exacerbation.