Acute Respiratory Failure Due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease: The Spectrum of Ventilator Strategies

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. Acute exacerbation of COPD is associated with a faster decline in lung function, lower quality of life, and increased mortality. Management of acute exacerbation of COPD in the intensive care unit includes pharmacotherapy and mechanical ventilatory support. Noninvasive mechanical ventilation has led to significant improvement in outcomes of COPD and reduced morbidity and mortality compared with invasive mechanical ventilation. An emerging modality, extracorporeal carbon dioxide removal is now being studied to reduce the need for ventilatory assistance in acute ventilatory failure due to COPD exacerbation.