Manejo de la exacerbación aguda severa de EPOC

AECOPD (acute exacerbation of chronic pulmonary disease) is a frequent motive of presentation to emergency services. When severe, it usually requires management at an intermediate or intensive care unit, where adequate monitoring and ventilatory assistance can be provided. A review was carried out of the literature on the evaluation, management, and follow-up of severe AECOPD, with emphasis on the rationale and indications of noninvasive mechanical ventilation (NIMV), as well as on the assessment of the patient once this therapy has been initiated. NIMV is currently the firstchoice treatment in patients with AECOPD with impending or actual hypercapnic ventilatory failure, and has shown significant benefits in terms of recovery and survival. It is important to supplement clinical evaluation with arterial blood gas analysis, which allows initial focusing and afterwards serves as a guideline for timely decisions.