A person with chronic obstructive pulmonary disease (COPD) experiences long-term, progressive damage to their lungs. This affects airflow to the lungs. Doctors sometimes call this condition emphysema or chronic bronchitis.
A person with COPD can experience a period when their symptoms are much worse than usual. This is known as an acute exacerbation. They may need to seek medical help at a hospital.
The average person with COPD has between 0.85 and 1.3 exacerbations a year.
COPD exacerbations can be harmful because they can cause further damage to the lungs. If you’ve been diagnosed with COPD, preventing an exacerbation from occurring can help you live a healthier life and reduce the risk of death.
If you have COPD, physical activity will typically leave you short of breath. You may not be able to do all the activities that a person without COPD can do. During an exacerbation, your symptoms can get much worse than usual.
Examples of COPD exacerbation symptoms include:
- breathing in a fast and shallow pattern, as if you’ve just exercised very intensely
- experiencing shortness of breath at rest or with minimal activity, such as walking from one room to another
- feeling excessively sleepy or confused
- having lower oxygen levels than normal
- noticing increasing amounts of mucus, which is often yellow, green, tan, or even blood-tinged
- wheezing more than usual
After your body uses oxygen, carbon dioxide is left on the inside. Your lungs are responsible for exchanging oxygen with carbon dioxide.
A person with COPD has more difficulty making this exchange because their lungs don’t work as well. This could lead to a buildup of carbon dioxide and reduced oxygen levels.
If carbon dioxide builds up in your body or oxygen levels become too low, it can become deadly. Symptoms of too much carbon dioxide in your body include:
- severe headache
- difficulty walking even short distances
- having a hard time catching your breath
If these symptoms occur, then it’s important to seek immediate medical attention.
A COPD exacerbation is usually triggered by inflammation in the lungs.
Infection or irritants can cause this inflammation. Examples include:
- seasonal allergens
- air pollution
If you have COPD, it’s important to take every step possible to avoid lung infection, such as getting flu shots annually. You’ll also need the pneumococcal vaccine.
However, about 33 percent of COPD exacerbations don’t have a known cause.
Because COPD causes limited lung function, it can keep you from exercising or moving around as much.
Limited lung function also makes you more likely to get an infection. When you have COPD, getting a cold or the flu can be more dangerous and cause more severe symptoms.
Some of the known complications associated with COPD include:
- depression, as having COPD can affect your ability to do things you enjoy
- heart problems, such as heart disease and an increased risk of heart attack
- pulmonary arterial hypertension, or high blood pressure in the arteries of the lungs
- lung cancer, as those with COPD often were or are smokers
Treatments for COPD exacerbations can depend on the severity of your symptoms.
Most people with COPD will start to notice a pattern for their symptoms. If you notice the symptoms of an exacerbation coming on early enough, you can get treatment before your symptoms worsen.
If your symptoms aren’t severe, your doctor may prescribe treatments for you to use at home. Examples of these include:
- Antibiotics: If bacteria caused your respiratory infection, taking antibiotics can help to slow the infection or stop it from getting worse.
- Inhalers: When the small, treelike parts of your lungs known as alveoli get narrow or fill with mucus, it’s harder to breathe. There are two types of inhalers: bronchodilators and steroid inhalers. Bronchodilators help to open the airways and make it easier to breathe. Examples include ipratropium/albuterol (Combivent Respimat) and levalbuterol (Xopenex). Steroid inhalers reduce lung inflammation and are sometimes combined, such as fluticasone/salmeterol (Advair).
- Steroids: These medications are designed to reduce lung inflammation, which leads to narrowing of and swelling in the airways. Methylprednisolone (Medrol) is one example.
At a hospital, your doctor may provide additional treatments to support your breathing. One example is the use of a continuous positive airway pressure (CPAP) device to help keep your lungs open.
Your doctor may also put you on a ventilator to help you breathe. In this case, you’ll stay in an intensive care unit until your infection clears up or your lungs become less inflamed.
You can help prevent COPD exacerbations by adopting certain self-care practices. These include:
- avoiding exposure to lung irritants, such as kerosene heaters, in your home
- avoiding large crowds during cold and flu season to prevent getting sick
- drinking plenty of fluids to prevent mucus from becoming too thick
- getting a yearly flu shot to prevent a respiratory infection
- keeping regular appointments with your healthcare provider, such as your pulmonologist
- monitoring your oxygen levels whenever possible, possibly with the health of a small device called a pulse oximeter
- practicing healthy habits, such as getting enough sleep at night and eating a healthy diet
- getting a pneumonia or pertussis shot when your healthcare provider recommends it
- quitting smoking or avoiding secondhand smoke
- washing your hands frequently and using hand sanitizer to prevent the spread of germs
Doctors classify COPD into four stages, from Group A to Group D. Group A has fewer symptoms and a low risk of exacerbations, while Group D has more symptoms and a higher risk of exacerbations.
Because the condition is chronic, you may progress through each of the stages. However, this usually occurs over many years.
These exacerbations can be deadly. If your lungs are functioning poorly, you might not be able to breathe without a ventilator. It’s also possible that a ventilator may not provide enough support for your lungs.
Preventive self-care measures like the ones mentioned earlier can reduce the likelihood of an exacerbation. Ask your doctor about additional steps you can take to prevent COPD exacerbations.