Every time they talk about the acute exacerbation of COPD, patients always have lingering fears and feel that they have “passed the gate of hell”, as an “inevitable” in the process of COPD Kan”, when we interviewed Dr. Lu Jinghui from Beijing Anzhen Community Health Service Center, she also introduced that, on average, COPD patients will have 2 to 3 exacerbations each year, and each attack has a significant impact on lung function. This kind of blow, how to identify and treat early is the most critical.
In addition to the yellow purulent sputum we often talk about, what symptoms should we be alert to in acute exacerbation of COPD?
Dr. Lu introduced that the prominent feature of acute exacerbation of COPD is the aggravation of airway inflammation, and increased cough and sputum production are more common in patients with acute exacerbation. For example, in the case of a patient coughing up sputum, there may be only two or three mouthfuls of white sticky sputum in the morning, but if it becomes two or three mouthfuls of yellow purulent sputum, or not only the coughing up of yellow purulent sputum, but also a particularly large amount, then one should be alert to acute sputum. possibility of aggravation.
The situation of coughing at the same time is also different from the past. It may have been just a few coughs in the morning, but now it has become an all-day cough. There is only sporadic coughing during the day, but at night the coughing persists, and you may have to toss until the second half of the night before you can fall asleep. In this case, you should be highly vigilant.
It is worth mentioning that many patients tend to ignore the decline in activity tolerance. Dr. Lu reminded that although patients with COPD will be limited in their daily activities, if they find that they can walk 600 meters before, Now they can only walk 400 meters, and some patients even start to get out of breath after walking 100 meters and need to stop. The “stop” during this exercise is also an early warning of acute aggravation.
What factors are associated with more acute exacerbations of COPD?
Dr. Lu introduced that among the many incentives, acute exacerbation of COPD is mainly related to respiratory virus infection, including rhinovirus, influenza virus, adenovirus and so on.
It is usually because the patient’s own immunity is weakened. Whether it is affected by the weather or because of physical exertion, cold symptoms appear, and the rhinovirus, which is itself fixed in our nasal cavity, will reignite. Then there is the familiar influenza A and B, the new coronavirus, etc., patients with chronic obstructive pulmonary disease are passively infected.
There are also many COPD patients who have long-term chronic bronchitis, the trachea and airway are not good enough, and the bacteria are fixed, so they are prone to secondary infection when their immunity is low.
What about an acute exacerbation of COPD? What conditions require hospitalization?
Dr. Lu introduced that once an acute exacerbation occurs, it is necessary to seek medical attention whether it is mild, moderate or severe. I have seen many patients with COPD clinically, and they will use their own empirical medication for empirical treatment. This approach is very inadvisable. It is likely to develop from a mild case that can be treated in an outpatient clinic to a need for hospitalization and ICU admission.
Generally speaking, if there is an acute exacerbation, it can only be treated as an emergency at home. For example, if there is wheezing, it is night, and the symptoms do not need to go to the emergency department, the patient can use the short-acting treatment. If you have fever, nasal congestion, runny nose, snorting, or obvious upper respiratory tract cold symptoms, you can take some cold medicines in time for the symptoms. has appeared.
Dr. Lu added that the acute exacerbation of COPD can progress from very mild to very severe. Whether it can be treated in an outpatient clinic or needs to be treated in a hospital needs to be judged by a professional outpatient doctor. If you feel that your symptoms are mild and do not receive standardized treatment, each acute exacerbation will lead to disease progression and rapid decline in lung function, forming a vicious circle.
As a chronic disease, most patients can receive timely and effective care during hospitalization, and their condition is relatively stable. The real challenge is how to manage their condition after discharge. Monitoring, where to find answers to common doubts…
This Saturday (August 20th) at 15:00-16:00 pm, we have the honor to invite Dr. Niu Hongtao from the Respiratory Center of the China-Japan Hospital to come The live program “Breathing of Happiness–Let Life Be Beautiful” in the live broadcast room of “Watching Breath” analyzed in detail “What is the most afraid of lung function with careful care?“, and answered questions from the audience online.
Doctor-patient interactive popular science live program “Breath of Happiness – Let Life Be Beautiful” is the most authoritative popular science communication platform in the field of respiratory diseases. Its biggest feature is to focus on building interconnection for doctor-patient connections bridge. Scan the QR code below the code, add a WeChat assistant, Join the patient group, Leave your needs and doubts, which will be the direction for us to determine the content of the topic. At the same time, you can also exchange disease resistance experience with patients in the patient group, share life, and gain strength.
Professional Profile Lu Jinghui
Attending physician; Anzhen Community Health Service Center. Graduated from Peking University School of Medicine, Ph.D. After graduating, he majored in respiratory and critical care. In 2018, he stayed in the United States. He studied at Harvard Medical School for postdoctoral research and published many academic papers. After returning to China at the end of 2019, he devoted himself to the clinical and research work of general practice.
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