Table 4.

Clinical conditions to consider in AECOPD patients for ICU admission.

Parameters To Consider to Admit in ICU a Patients with AECOPD

Very severe symptoms (dyspnoea) that respond inadequately to initial emergency therapy Acute respiratory failure with use of accessory respiratory muscles and change in mental status Persistent/worsening hypoxemia (paO2 < 40–45 mmHg) Persistent/worsening severe respiratory acidosis (pH < 7.25) Worsening of respiratory acidosis despite non-invasive mechanical ventilation Need for invasive mechanical ventilation Hemodynamic instability (need for vasopressors) High-risk comorbidities or conditions (pneumonia, heart failure, cardiac arrhythmia, chronic renal failure, liver failure, immunodeficiency, or malignancy) Changes in mental status (confusion, lethargy, or coma) Other concomitant organ failure (e.g., acute renal failure) Age > 65 years old Depression Absence of care giver History of AECOPD requiring intubation and mechanical ventilation