Factors affecting development of acute exacerbations of chronic obstructive pulmonary disease

The characteristics of exacerbations of chronic obstructive pulmonary disease (COPD) are presented. It is emphasized that the exacerbation of COPD can develop by two ways; first way is characterized by increasing inflammatory syndrome, and the second - by progressive dyspnea and increased extrapulmonary manifestations of COPD. Among the factors contributing to the exacerbation of COPD, the leading role belongs to the effects of bacterial and/or viral infection of bronchial tree, primarily Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis (10-30%). In addition to infectious agents, the cause of COPD exacerbations in about half the cases may be non-infectious factors, among which the leading role belongs to atmospheric pollutants. In patients with COPD, CAD, bronchial asthma and gastroesophageal reflux disease are frequent comorbidities affecting course of disease, including exacerbations. Physicians in the treatment of exacerbation must take into account all the peculiarities of manifestations, the nature and severity, because acute exacerbation of COPD is associated with high mortality.

chronic obstructive pulmonary disease, acute respiratory failure, bacterial infection, pollutants, gastroesophageal reflux disease