EDITORIAL
COPD exacerbation
Chronic obstructive pulmonary disease exacerbation and risk of pulmonary embolism
Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, University College London, Hampstead, UK
Correspondence to:
Correspondence to:
Professor J A Wedzicha
Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, University College London, Rowland Hill Street, Hampstead NW3 2PF, UK;j.a.wedzicha@medsch.ucl.ac.uk
Pulmonary embolism is not a common feature in patients with chronic obstructive pulmonary disease with uncomplicated exacerbations
| The first 150 words of the full text of this article appear below. |
Exacerbations of chronic obstructive pulmonary disease (COPD) are episodes of acute deterioration in respiratory symptoms1 that are accompanied by physiological changes2 and associated with increases in airway and systemic inflammation.3,4 These episodes are responsible for considerable morbidity and mortality, especially in patients with more severe COPD.5 There is consequently much interest in understanding the underlying pathophysiology of exacerbations and determining their triggers, so that appropriate interventions can be designed to prevent these events, reduce their severity and thus improve health status.
We now recognise that respiratory infections are important triggers of exacerbation. Respiratory viral infections, especially with human rhinovirus (the cause of the common cold), influenza and respiratory syncytial virus may be isolated from up to 60% of exacerbations.6,7 Exacerbations where a virus is isolated have increased airway and systemic inflammatory changes.3,8 The role of bacteria at exacerbation has been more difficult to determine as airway bacteria are
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