Acute asthma and chronic obstructive pulmonary disease (COPD) exacerbations are the most common respiratory diseases requiring emergent medical evaluation and treatment. Asthma and COPD are chronic, debilitating disease processes that have been differentiated traditionally by the presence or absence of reversible airflow obstruction. Asthma and COPD exacerbations impose an enormous economic burden on the US health care budget. In daily clinical practice, it is difficult to differentiate these 2 obstructive processes based on their symptoms, and on their nearly identical acute treatment strategies; major differences are important when discussing anatomic sites involved, long-term prognosis, and the nature of inflammatory markers.
Key points
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Management of severe asthma and chronic obstructive pulmonary disease (COPD) exacerbations require similar medical interventions in the acute care setting.
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Capnography, electrocardiography, chest x-ray, and ultrasonography are important diagnostic tools in patients with undifferentiated shortness of breath.
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Bronchodilators and corticosteroids are first-line therapies for both asthma and COPD exacerbations.
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Noninvasive ventilation, magnesium, and ketamine should be considered in patients with severe symptoms and in those not responding to first-line therapy.
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A detailed plan reviewed with the patient before discharge can decrease the number of future exacerbations.
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