ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a common lung condition characterised by shortness of breath, chronic cough, wheeze and regular sputum production. The main risk factor for the development of COPD is tobacco smoking, but it can also be caused by air pollution or industrial exposures. Acute exacerbations of COPD are a frequent cause of admission to the hospital, and of subsequent referral to critical care. The sick patient with COPD requires appropriate initial assessment and accurate diagnosis. Pharmacological therapy for an exacerbation of COPD consists of acute bronchodilator therapy, controlled oxygen therapy, oral steroids, and antibiotic therapy as per local guidelines. Some patients will require ventilator support despite the best medical management. This can be provided using a non-invasive or invasive approach, although neither is provided without considerable discomfort to the patient. Non-invasive ventilation (NIV) refers to ventilator support, which is provided without the need for an endotracheal tube or tracheostomy.