Acute respiratory failure in chronic obstructive pulmonary disease.

Clinically significant chronic obstructive pulmonary disease is a common and important disorder in the United States. As many as 15 million individuals suffer from chronic obstructive pulmonary disease, many of whom have disease requiring hospital or ICU admission. Acute respiratory failure in patients with chronic obstructive pulmonary disease is one of the most common causes of admission to the ICU for this patient population. In this article I address common issues regarding diagnosis and management of acute respiratory failure in chronic obstructive pulmonary disease. Acute respiratory failure will be defined as well as the common and unusual etiologies of acute respiratory failure. Pharmacologic and nonpharmacologic treatment will be addressed, especially the ventilatory treatment of the intubated patient with chronic obstructive pulmonary disease. Special attention has been made to included the most recent investigations regarding diagnosis and treatment of the patient with chronic obstructive pulmonary disease and respiratory failure.