1st-order laboratory parameters-obligatory laboratory tests.
- ESR (blood sedimentation rate).
- Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin).
- CRP-guided antibiotic prescription → decrease in antibiotic therapy.
- Blood count [note: blood eosinophils and exacerbation rate determine whether or not to take an inhalable corticosteroid (ICS) in COPD]
- Blood gas analysis (ABG) [art. Blood gases – COPD: abnormal between exacerbations of severe COPD; asthma: normal between exacerbations; most common cause of CO 2 elevation is exacerbation of COPD]
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- NT-proBNP (N-terminal pro brain natriuretic peptide): marker of myocardial wall tension (of the heart muscles) – for suspected heart failure (cardiac insufficiency).
- Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – may indicate myocardial damage [during acute exacerbation, a troponin increase is found in about 50% of COPD patients].
- In infectious exacerbation (marked worsening of the clinical picture due to infection):
- Bacteriology (cultural) sputum, tracheal secretions, bronchial secretions for pathogens and resistance.
- Antigen detection: influenza, RSV (respiratory syncytial virus), mycoplasma, Legionella if necessary.
- Direct detection (PCR): Legionella pneumophila, Chlamydophila pneumoniae, Mycoplasma pneumoniae, Bordetella pertussis/parapertussis, Bocaparvovirus (until 2015 Bocavirus), Adenovirus, Rhinovirus, Influenza TypeA/TypeB, Parainfluenza Type 1,2,3, RSV, Human Metapneumovirus, Human Coronaviruses, Enteroviruses (Coxsackie, Polio, Picorna, ECHO).
- Serology: detection of antibodies against chlamydia, adenoviruses, Coxsackie viruses, ECHO viruses, influenza A/B viruses, parainfluenza viruses, RSV (respiratory syncytial virus).
- Blood gas analysis (BGA) – to study lung function in severe courses.
- Alpha-1 antitrypsin – to exclude alpha-1 antitrypsin deficiency.
- SuPAR (soluble urokinase-type plasminogen activator receptor; inflammatory marker) – predictor of acute exacerbations in patients with COPD and for monitoring response to therapy.
