Chronic obstructive pulmonary disease patient journey: hospitalizations as window of opportunity for extra-pulmonary intervention.

PURPOSE OF REVIEW: Hospitalizations due to exacerbation of chronic pulmonary disease (COPD) are a major burden for patient and healthcare Extra-pulmonary needs and resulting interventions are poorly FINDINGS: COPD induces nutritional issues, body composition changes and patient exercise capacity. The COPD patient journey can be accelerated exacerbations during which disease-related detrimental factors such as inflammation, hypoxia, inactivity, and glucocorticosteroid treatment intensify, which acutely and often irreversibly worsens patient Specific needs during exacerbations reach beyond the respiratory system, clinicians should comprehensively evaluate patients and identify potent feasible metabolic and anabolic intervention targets. General and nutritional support appear feasible and with potential to cover for the bodily requirements during exacerbation. Adjunctive physical exercise or neuromuscular electrical stimulation may prevent the muscle loss. Hospitalizations should be considered as a window of opportunity for patient assessment and implementation of tailored extra-pulmonary strategies with long-term implications. Nutritional assessment and well as physical exercise appear promising but should be investigated in adequately designed and conducted trials.