Chronic Obstructive Pulmonary Disease Exacerbation

ExitCare ImageChronic obstructive pulmonary disease (COPD) is a condition that limits airflow. COPD may include chronic bronchitis, pulmonary emphysema, or both. COPD exacerbation means that your COPD has gotten worse. Without treatment, this can be a life-threatening problem. COPD exacerbation requires immediate medical care.


COPD exacerbation can be caused by:

  • Exposure to smoke.

  • Exposure to air pollution, chemical fumes, or dust.

  • Respiratory infections.

  • Genetics, particularly alpha 1-antitrypsin deficiency.

  • A condition in which the body's immune system attacks itself (autoimmunity).



  • Increased coughing.

  • Increased wheezing.

  • Increased shortness of breath.

  • Swelling due to a buildup of fluid (peripheral edema) related to heart strain.

  • Rapid breathing.

  • Chest enlargement (barrel chest).

  • Chest tightness.


There is no single test that can make the diagnosis of COPD exacerbation. Your history, physical exam, and other tests will help your health care provider make a diagnosis. Tests may include a chest X-ray, pulmonary function tests, spirometry, basic lab tests, and an arterial blood gas test.


Severe problems may require a stay in the hospital. Depending on the cause of your problems, the following may be prescribed:

  • Antibiotic medicines.

  • Bronchodilators (inhaled or tablets).

  • Cortisone medicines (inhaled or tablets).

  • Supplemental oxygen therapy.

  • Pulmonary rehabilitation. This is a broad program that may involve exercise, nutrition counseling, breathing techniques, and further education about your condition.

It is important to use good technique with inhaled medicines. Spacer devices may be needed to help improve drug delivery.


  • Do not smoke. Quitting smoking is very important to prevent worsening of COPD.

  • Avoid exposure to all substances that irritate the airway, especially tobacco smoke.

  • If prescribed, take your antibiotics as directed. Finish them even if you start to feel better.

  • Only take over-the-counter or prescription medicines as directed by your health care provider.

  • Drink enough fluids to keep your urine clear or pale yellow. This can help thin bronchial secretions.

  • Use a cool mist vaporizer. This makes it easier to clear your chest when you cough.

  • If you have a home nebulizer and oxygen, continue to use them as directed.

  • Maintain all necessary vaccinations to prevent infections.

  • Exercise regularly.

  • Eat a healthy diet.

  • Keep all follow-up appointments as directed by your health care provider.


  • You have extreme shortness of breath.

  • You have trouble talking.

  • You have severe chest pain or blood in your sputum.

  • You have a high fever, weakness, repeated vomiting, or fainting.

  • You feel confused.

  • You keep getting worse.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.