During an acute exacerbation of COPD, what is the role of IV ...

[RRMR]

During an acute exacerbation of COPD, what is the role of IV methylprednisolone?
 
  a. It accelerates recovery as noted in FEV1.
  b. It causes pulmonary edema due to reten-tion of water.
  c. It causes severe immunosuppression and worsens outcomes.
  d. It has been shown to have no effect.

Question 2

A patient is experiencing an exacerbation of COPD. He is 65 years old, slim, and in notable dis-tress with tachypnea, tachycardia, and an arterial blood pH of 7.29. Which of the following therapies would be most indicated?
 
  a. Intrapulmonary percussive ventilation
  b. Intubation and mechanical ventilation
  c. Nasal CPAP
  d. Noninvasive ventilation

[Joy Chen]

Answer to Question 1

ANS: A
An early randomized controlled trial of IV methylprednisolone for patients with acute exacerba-tions has shown accelerated improvement in FEV1 within 72 hr.

Answer to Question 2

ANS: D
Criteria defining candidacy for noninvasive ventilation include acute respiratory acidosis (with-out frank respiratory arrest), hemodynamic stability, ability to tolerate the interface needed for noninvasive ventilation, ability to protect the airway, and lack of craniofacial trauma or burns, copious secretions, or massive obesity.

[RRMR]

Gracias!

[LVPMS]

Excellent