Chronic obstructive lung disease and acute respiratory failure.

Patients with chronic obstructive lung disease (COLD) experience one or more episodes of acute respiratory failure in the late years of their illness. Initial evaluation is aimed at assessing the precipitating factor or factors as well as the severity of the acute episode and the need for intubation and mechanical ventilation. Specific treatment is directed toward the individual precipitating cause, as well as toward the general relief of hypoxemia and airflow obstruction. The prognosis for recovery from most episodes of acute respiratory failure is excellent and warrants an aggressive approach.