This protocol addresses unspecified respiratory failure occurring in the context of an acute exacerbation of chronic obstructive pulmonary disease (COPD) complicated by acute hypercarbia — a presentation that requires a targeted ventilatory and oxygenation strategy.

Clinical Scenario

The patient presents with unspecified respiratory failure in the setting of:

Acute exacerbation of chronic obstructive pulmonary disease (COPD)
Acute hypercarbia

Clinical Goals

The primary objective is maintaining adequate oxygenation within a range defined specifically for COPD physiology. The full protocol specifies the precise oxygenation threshold and what constitutes adequate saturation in this population.

Treatment Approach (Partial Overview)

Management involves a defined oxygenation strategy alongside bilevel positive airway pressure (bilevel-PAP) as the recommended ventilatory support modality for this COPD-with-hypercarbia presentation. The complete protocol — including precise targets, clinical criteria, and the full treatment algorithm — is available via the structured regimen below.

Full criteria and sequencing not shown here.

References

In patients with acute exacerbation of chronic obstructive pulmonary disease (COPD), an SaO2 of 88% to 92% is considered an adequate oxygenation target, as suggested by a recent observational study.
The European Respiratory Society (ERS)/ATS guidelines recommend bilevel positive airway pressure (bilevel-PAP) for patients with acute exacerbation of COPD accompanied by acute hypercarbia, CPAP for cardiogenic pulmonary edema, and NPPV for post-operative setting and early ARF in immunosuppressed patients.

DOI: 10.1186/s40560-023-00658-3

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Unspecified Respiratory Failure in Acute Exacerbation of COPD with Acute Hypercarbia

Clinical Scenario

Clinical Goals

Treatment Approach (Partial Overview)

References