RT Journal Article
T1 Spanish COPD Guidelines (GesEPOC) 2021 Update Diagnosis and Treatment of COPD Exacerbation Syndrome.
T2 Actualización 2021 de la guía española de la EPOC (GesEPOC). Diagnóstico y tratamiento del síndrome de agudización de la EPOC.
A1 Soler-Cataluña, Juan José
A1 Piñera, Pascual
A1 Trigueros, Juan Antonio
A1 Calle, Myriam
A1 Casanova, Ciro
A1 Cosío, Borja G
A1 López-Campos, José Luis
A1 Molina, Jesús
A1 Almagro, Pere
A1 Gómez, José-Tomás
A1 Riesco, Juan Antonio
A1 Simonet, Pere
A1 Rigau, David
A1 Soriano, Joan B
A1 Ancochea, Julio
A1 Miravitlles, Marc
A1 en representación del grupo de trabajo de GesEPOC 2021, 
K1 Agudización
K1 COPD
K1 Exacerbation
K1 Rasgos tratables
K1 Syndrome
K1 Síndrome
K1 Treatable traits
K1 enfermedad pulmonar obstructiva crónica
AB This article details the GesEPOC 2021 recommendations on the diagnosis and treatment of COPD exacerbation syndrome (CES). The guidelines propose a definition-based syndromic approach, a new classification of severity, and the recognition of different treatable traits (TT), representing a new step toward personalized medicine. The evidence is evaluated using GRADE methodology, with the incorporation of 6 new PICO questions. The diagnostic process comprises four stages: 1) establish a diagnosis of CES, 2) assess the severity of the episode, 3) identify the trigger, and 4) address TTs. This diagnostic process differentiates an outpatient approach, that recommends the inclusion of a basic battery of tests, from a more comprehensive hospital approach, that includes the study of different biomarkers and imaging tests. Bronchodilator treatment for immediate relief of symptoms is considered essential for all patients, while the use of antibiotics, systemic corticosteroids, oxygen therapy, and assisted ventilation and the treatment of comorbidities will vary depending on severity and possible TTs. The use of antibiotics will be indicated particularly if sputum color changes, when ventilatory assistance is required, in cases involving pneumonia, and in patients with elevated C-reactive protein (≥ 20 mg/L). Systemic corticosteroids are recommended in CES that requires admission and are suggested in moderate CES. These drugs are more effective in patients with blood eosinophil counts ≥ 300 cells/mm3. Acute-phase non-invasive mechanical ventilation is specified primarily for patients with CES who develop respiratory acidosis despite initial treatment.
YR 2021
FD 2021-05-26
LK http://hdl.handle.net/10668/21989
UL http://hdl.handle.net/10668/21989
LA en
LA es
DS RISalud
RD Apr 19, 2025