A patient with an exacerbation of chronic obstructive pulmonary disease (COPD) may require hospitalization and/or intensive care if s/he experiences deterioration in pulmonary function.
Indications for hospitalization - one or more of the following:
(1) significant pulmonary symptoms not responding to outpatient management
(2) new or worsening hypoxia
(3) new or worsening hypercapnia
(4) new or worsening cor pulmonale
(5) new or worsening comorbid conditions that exacerbate respiratory symptoms
(6) inability to care for self as an outpatient
Indications for admission to the ICU - one or more of the following:
(1) persistent or worsening hypoxemia despite maximal oxygen supplementation
(2) requires assisted ventilation
(3) severe or worsening respiratory acidosis (pH < 7.30)
(4) evidence of impending respiratory failure
(5) deterioration in mental status (confusion or lethargy)
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