Exacerbated COPD
Escalation levels
In the event of imminent respiratory muscle fatigue, set pressure support (ASB).
Immediate intubation in the absence of clinical improvement or the occurrence of
contraindications!
Caution
• Continuous clinical observation and close patient contact
• No delay in pharmacological therapy or necessary intubation
• Prepared for intubation at any time
• Timely advance information to the receiving hospital
Primary device settings
Ventilation mode: ................................................................................. CPAP + ASB
PEEP: .........................................................................................................3/6mbar
∆pASB (according to comfort and oxygenation): .................................5/10/15mbar
Peak pressure (pMax): ........................................................................ max. 25mbar
Inspiration trigger: ........................................................................as low as possible
Pressure ramp: .................................................................................................steep
FiO
2
: ..............................................................................................Air Mix or 100%
Aim and success criteria
Target SpO
2
: >85% ....................................................................................... Check
Decrease in dyspnea ...................................................................................... Check
Falling respiratory and heart rate .................................................................... Check
If applicable, improved vigilance ..................................................................... Check
Escalation levels
In the event of imminent respiratory fatigue, if available, set ventilation mode
BiLevel + ASB (e.g. PEEP: 5mbar, pInsp: 20mbar).
Immediate intubation in the absence of clinical improvement or the occurrence of
contraindications!
Caution
• Continuous clinical observation and close patient contact
• No delay in pharmacological therapy or necessary intubation
• Prepared for intubation at any time
• Timely advance information to the receiving hospital