💨 COPD Acute Exacerbation (AECOPD) Management
This tool applies the Anthonisen cardinal symptoms and ventilation needs to judge the antibiotic indication in AECOPD and frames steroid, bronchodilator, oxygen, and ventilation therapy.
COPD Acute Exacerbation (AECOPD) Management
Worsening dyspnea
Increased sputum volume
Sputum purulence
Needs invasive or noninvasive ventilation
Arterial pH (optional)
Pseudomonas aeruginosa risk factors
When to use
Use to decide whether antibiotics are indicated and to set the steroid course, controlled-oxygen target, and noninvasive ventilation threshold.
How it works
Antibiotics if all three cardinal symptoms, two including purulence, or ventilation needed. Prednisolone 40 mg/d × 5 days; SABA ± SAMA; oxygen SpO₂ 88–92%; NIV at pH < 7.35 or severe dyspnea.
Key points
- Sputum purulence is the pivotal cardinal symptom — two symptoms only trigger antibiotics when purulence is one of them. (original synthesis · not guideline verbatim)
- Controlled oxygen targets SpO₂ 88–92% to avoid CO₂ retention in chronic hypercapnia.
- Pseudomonas risk factors shift empiric therapy to an anti-pseudomonal regimen with cultures.
References
- Global Initiative for Chronic Obstructive Lung Disease. GOLD Report 2024.
- Anthonisen NR, et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.