New GOLD Guidelines for COPD Exacerbations

  • Beta2-agonists and anticholinergics are the initial bronchodilators
  • Prednisone 1 mg/kg/day (up to 60 mg/day) or steroid equivalent for moderate-severe exacerbations x 5-7 days
  • Antibiotics indicated for moderate-severe exacerbations with pulmonary infiltrate or sputum purulence

–procalcitonin level >0.25 ng/mL supports antibiotic use

–Consider for pH<7.35 and PaCO2>45

  • Mechanical ventilation indicated for:

–Hemodynamic instability

–Failure of NPPV

–Decreased level of consciousness or severe agitation

–Life-threatening hypoxemia


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Read all articles in Endocrinology, Mechanical Ventilation, Medical General, Respiratory diseases
Tags: COPD, HPC updates, mechanical ventilation, noninvasive ventilation, procalcitonin, steroids

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