Hydration

• Maintain adequate hydration to prevent excessive mucus viscosity

Nutritional Programs

• There are no direct or measurable effects on lung function in treating malnutrition but subjective relief and objective improvement in strength and exercise performance do occur
  • Dietary supplementation should be considered if patient is malnourished (body weight <85% of ideal) or experiencing early satiety

• Advise patient to obtain nutritional counseling to reduce weight if obese

Oxygen Therapy

• Cornerstone of COPD exacerbation treatment
• Low-flow O₂ should be administered if hypoxemia is present
• Excess use of O₂ should be avoided as this may lead to progressive hypercapnia, either by decreasing hypoxic ventilatory drive or by worsening ventilation-perfusion mismatching within the lung
• Once O₂ therapy is initiated, arterial blood gas should be monitored 30-60 minutes later to ensure satisfactory oxygenation without acidosis or CO₂ retention
• Goal of supplemental O₂ therapy should be arterial oxygen partial pressure at or just above 60 mmHg

Noninvasive Positive Pressure Ventilation

• Frequently used for inpatient management of AECB patients who are significantly hypoxemic or with a serum pH <7.3
• Improves ventilation and lower pCO₂ levels and may be a means of avoiding intubation
• Decreases hospital or intensive care unit length of stay and morbidity