All right, so welcome back to the Internet Book of Critical Care Podcast.

I'm here with Adam Thomas and we're going to talk about all things acute exacerbation

of COPD.

Josh, if you had to say what percentage of your mortgage was paid by exacerbation of COPD,

what would you say?

I don't want to think about it.

Yeah.

So today we will cover one of the hallmark presentations for both hospital-based medicine

and in particular critical care.

So today's the acute exacerbation of COPD.

So today, diagnosis work up.

The pathophysiology, and hopefully we don't piss off as many people with this post as we did

with the asthma. Of course, the basic treatments, and then we'll get into some controversial stuff.

So, Josh, let's head straight into your huffing and puffing, and you got the COPD.

Let's back up and think about the key differential in this patient population.

This is basically just going to be the differential diagnosis of respiratory failure.

So I think the key point here is just to keep in mind that folks with COPD can develop all sorts

of other disorders and in some ways they may be more likely to develop other problems because

they have all these comorbidities. So just because they have COPD and they come in and they're

wheezing doesn't mean they may not have heart failure or pulmonary embolism or the COPD, obesity, hypolencellation

syndrome overlap, all these different things. And of course, how could I fail to mention the patient

with COPD who's on chronic opiates? Because we have so many of those and it's a huge problem.

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