Acute respiratory failure and chronic obstructive lung disease.

Patients with COPD who develop acute respiratory failure require special attention in their management. Patients with severe COPD often have cor pulmonale, complex acid/base compensations, and altered respiratory control mechanisms. These need to be considered when approaching the patient with an acute decompensation. Because of the improving prognosis in this group of patients, aggressive management should be undertaken using combinations of bronchodilator medications, oxygen, bronchial hygiene, and antibiotics.