Acute Exacerbations

An acute exacerbation of chronic obstructive pulmonary disorder (COPD) is a sudden worsening of symptoms of the disease. Acute exacerbations are also called COPD “attacks” or “flare-ups.”

These COPD attacks can be very frightening for the patient, especially because they can happen so suddenly. However, the right kind of treatment can often bring an attack under control fairly quickly.1

What are the signs of a COPD flare-up?

During a COPD attack, a patient has symptoms that are much worse than usual.2 These symptoms can include:

  • Feeling short of breath or breathless
  • Coughing
  • Fever
  • Increased amount of mucus
  • Change in color of the mucus: from clear to yellow, green, brown, or red

What causes acute exacerbations of COPD?

Two common causes of COPD attacks are:

Infections and air pollution trigger COPD attacks by causing the lungs to become irritated and inflamed. However, around 30% of exacerbations have an unknown cause.3,4

Some COPD patients are more likely than others to have COPD attacks, for reasons that are not understood. Patients who have two or more COPD attacks in a single year have a higher risk of having these attacks in the future. COPD patients at an advanced stage of the disease have lungs that are less able to fight off infections. So, they are likely to have COPD attacks more often than patients in earlier stages of the disease.

How are acute exacerbations treated?

COPD attacks can have a harmful effect on a COPD patient’s quality of life, particularly if they happen on a regular basis. For this reason, it is crucial for patients to be ready to treat the symptoms of COPD attacks as quickly as possible.

Using medications for acute exacerbations

Special kinds of medications called “inhaled bronchodilators” can be useful for immediately treating the symptoms when a COPD attack hits. Healthcare providers should prescribe their COPD patients with the right kind of inhalers to have on hand for treating COPD attacks. Using supplemental oxygen or taking other types of medications called corticosteroids can also help relieve the symptoms of the attack.

If an infection in the respiratory system is causing the COPD attack, then the person usually has symptoms like fever or a change in mucus color. Antibiotics can treat the infection and relieve the symptoms.

Sometimes hospitalization is necessary for flare-ups

If the COPD attack is very severe, then the patient may need to spend time in the hospital to receive treatment. At the hospital, chest x-rays and blood tests help healthcare providers decide the best way to treat the exacerbation. While in the hospital, the patient might be treated with:

  • IV medications and antibiotics
  • Supplemental oxygen
  • Ventilator to help with breathing

COPD attacks can be dangerous – they can even lead to lung failure if they are not treated in the right way. If at-home treatment is not working well enough to relieve the symptoms, then the patient still might find it too difficult to breathe. If that happens, patients should contact their healthcare provider immediately and/or go to the emergency room.2,3,5,6

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Written by: Anna Nicholson | Last reviewed: July 2015.