GOLD 2024 — Global Strategy for the Diagnosis, Management, and Prevention of COPD
Global Initiative for Chronic Obstructive Lung Disease, 2024
This guideline has been superseded by a newer recommendation. Check the Knowledge Map or the current topic page for the guideline that replaces it.
Noninvasive positive pressure ventilation (NIV) is the first-line ventilatory support for acute hypercapnic respiratory failure (pH < 7.35, PaCO2 > 45 mmHg) in COPD. Systemic corticosteroids should be given for 5 days (oral prednisone 40 mg daily). Antibiotics are indicated for patients with all 3 cardinal Anthonisen symptoms or those requiring mechanical ventilation.
Clinical Context & Relevant Topics (2)
Disease ReferencePathophysiology of acute-on-chronic hypercapnia, controlled oxygen targets (88–92%), evidence-based NIV, and auto-PEEP matching mechanics.
Mechanism-based diagnosis of acute and acute-on-chronic hypercapnia, controlled oxygen, NIV, invasive ventilation, auto-PEEP troubleshooting, neuromuscular monitoring, and post-acute planning.