Tom's story, invasive mechanical ventilation

Tom’s Story - COPD

Invasive mechanical ventilation

Case summary

  • 72 year old male with severe COPD
  • COPD is managed by long term home care, multiple previous hospitalisations
  • Over the last 2 days experienced worsening dyspnea, cough, and increasing of sputum purulence
  • Presents in ED from ambulance with acute respiratory failure due to severe COPD exacerbation, intubated in ED and transferred to ICU


  • Mechanically ventilated for 3 days
  • Beta-agonists and anticholinergics nebulised in-line via Aerogen Solo every 2-4 hours
  • Corticosteroids and antibiotics via IV

Patient outcomes

  • Weaned to high-flow nasal canula with continued treatments in-line
  • Weaned to treatments via Aerogen Ultra and moved to wards
  • Discharged home, partially dependent

Not based on a specific patient but are representative of common clinical situations. Patient journey developed based on: Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: (Accessed on February 28, 2022).
National Institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2018). (Accessed on February 03, 2020).
James K Stoller, MD, MS. COPD Exacerbations. In: Post TW, ed. COPD exacerbations: Management. UpToDate; 2022. Accessed July 11, 2022.

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