What are the Different Types of COPD Exacerbations?

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that results in damaged respiratory tract tissue, restricted airways, and difficulty breathing. The condition is characterized by episodes during which symptoms worsen. Those episodes are known as COPD exacerbations and can involve shortness of breath upon exertion, coughing with an increase or change in sputum brought up from the respiratory tract, wheezing, a sensation of tightness in the chest, fever, and fatigue.

COPD is a disease for which there is no known cure, and treatment targets the management of symptoms that are chronic and persistent. These symptoms worsen during COPD exacerbations, and can vary depending on the severity of the lung disease. Exacerbations of Stage I, or mild COPD, to Stage II, or moderate COPD, often include shortness of breath upon exertion and a cough that brings up mucus and other matter from the respiratory tract. During an exacerbation, this matter, or sputum, could be different in quantity, color, and thickness than is typical for the patient.

In Stage III, or severe COPD, exacerbations involve more pronounced difficulty breathing as inflammation in the airways results in further reduced airflow. Capacity for the relatively minor exertion of daily activities is compromised. Exacerbations in Stage IV, or very severe COPD, can be life threatening as it may involve fever, profound shortness of breath, and even respiratory failure.

One of the most common causes of COPD exacerbations is smoking and exposure to second-hand smoke. Other causes include improper use of inhalers and other respiratory devices and failure to follow prescribed drug therapy and rehabilitation programs. COPD exacerbations often can be brought on by other illnesses, including respiratory infections and viruses, as well as gastrointestinal reflux disease (GERD). Triggers also can come from environmental factors, such as air pollution and extreme temperatures.

Treatment options for COPD exacerbations depend upon the stage of COPD, and the correlated severity of symptoms. Patients may be treated at home or in the hospital using therapies including antibiotics, bronchodilators, supplemental oxygen and ventilator support. The best strategy for treating a COPD exacerbation may be to prevent it from occurring by avoiding potential triggers and following a physician's advice and prescribed therapy. In some cases, physicians may prescribe a pulmonary rehabilitation program in an effort to minimize COPD exacerbations and improve the patient's overall quality of life. This type of program might include exercise training, nutritional planning, counseling, and education.