Management of COPD exacerbations: axc2xa0European Respiratory Society/American Thoracic Society guideline

[摘要] This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations.Comprehensive evidence syntheses; including meta-analyses; were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations; Assessment; Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts.After considering the balance of desirable and undesirable consequences; quality of evidence; feasibility; and acceptability of various interventions; the Task Force made: 1) a strong recommendation for noninvasive mechanical ventilation of patients with acute or acute-on-chronic respiratory failure; 2) conditional recommendations for oral corticosteroids in outpatients; oral rather than intravenous corticosteroids in hospitalised patients; antibiotic therapy; home-based management; and the initiation of pulmonary rehabilitation within 3xe2x80x85weeks after hospital discharge; and 3) a conditional recommendation against the initiation of pulmonary rehabilitation during hospitalisation.The Task Force provided recommendations related to corticosteroid therapy; antibiotic therapy; noninvasive mechanical ventilation; home-based management; and early pulmonary rehabilitation in patients having a COPD exacerbation. These recommendations should be reconsidered as new evidence becomes available.

[学科分类] 呼吸医学