#378 Acute Exacerbations of COPD (AECOPD)

Acute exacerbations of COPD require a systematic approach to diagnosis and management, beginning with a thorough clinical evaluation to distinguish between simple exacerbations and more severe processes like pneumonia or pulmonary embolism. Dr. Jim O'Brien emphasizes that while systemic steroids remain a cornerstone of therapy, clinicians should tailor dosing to the individual patient rather than relying on rigid protocols. Antibiotic selection must account for risk factors like colonization with Pseudomonas or MRSA, especially in patients with prior broad-spectrum exposure. Non-invasive ventilation, particularly BiPAP, serves as a critical intervention to reduce work of breathing and improve hypercapnia, provided the patient can synchronize with the device. Long-term management focuses on optimizing inhaler regimens and ensuring early follow-up within two to four weeks post-discharge to prevent recurrent hospitalizations and address underlying social determinants of health.