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What Is an Exacerbation?

Exacerbation means worsening or a "flare up" of COPD. An exacerbation can be from an infection in the lung, but in some instances it is never known why people have a worsening of symptoms. An exacerbation is usually treated with antibiotics even if the reason for the exacerbation is not known. Some healthcare providers believe that early treatment with antibiotics may prevent the process from getting worse. Whatever the reason for your exacerbation, you should contact your healthcare provider if your symptoms worsen (breathlessness, cough, sputum production).

How do I know I’m having an exacerbation?

Signs and symptoms of an exacerbation are similar to those of an infection or pneumonia. The amount and color of your sputum is important to note. A change in the amount of sputum (either bringing up more or bringing up less than usual), a change in the color of your sputum from clear to deep yellow, green, brown or red, and increasing shortness of breath are typical signs and symptoms of an exacerbation.

If I am hospitalized, what can I expect?

If you are hospitalized for complications of your COPD, you will probably be given antibiotics (and other medications intravenously), oxygen, have chest-x rays taken and several blood tests. These tests help guide your healthcare provider in how best to treat you. Sometimes, despite all treatment, the lungs are unable to adequately take in oxygen. In this case, you may require a ventilator to help you breathe (see Planning for the Future). Once on a ventilator, it may be a slow process removing you from the ventilator. In some cases, when the infection begins to go away, a person can be removed from the ventilator in just a few days. At other times, it may take weeks or months for the lungs to gain the strength needed to breathe without the help of a ventilator. There are also times when the person is not able to breathe again without a ventilator. This condition is called ventilator dependency. You, your family and your healthcare provider should discuss what you would like done if you are ever in a position where you will require a ventilator temporarily or permanently. Your views and preferences for a ventilator or any other therapy can be outlined in documents called advanced directives.

Will I be admitted to the hospital?

While you may experience more shortness of breath than usual with an exacerbation, acute bronchitis or pneumonia, these conditions do not necessarily require hospitalization. Many medications are now available to prevent hospitalization. Your provider will determine whether you need to be hospitalized based on your history and symptoms.

Last Reviewed: February 2015