Burge and Wedzicha used a scale to grade an exacerbation for a patient with chronic obstructive pulmonary disease (COPD). These can help to identify a patient who may benefit from more aggressive management. The authors are from Birmingham Heartlands Hospital and St. Bartholomew's and Royal London School of Medicine.
Parameters:
(1) therapy
(2) hypoxemia (PaO2 < 60 mm Hg)
(3) carbon dioxide retention (PaO2 > 45 mm Hg)
(4) acidosis (pH < 7.35)
Therapy
Hypoxemia
Carbon Dioxide Retention
Acidosis
Grade
antibiotics only
absent
absent
absent
mild
parenteral corticosteroids with or without an antibiotic
absent
absent
absent
moderate
NA
present
absent
absent
severe
NA
present
present
absent
very severe
NA
present
present
present
life-threatening
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