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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 dyspnoea, cough, and increasing sputum purulence
- Presents in ED from ambulance with acute respiratory failure due to severe COPD exacerbation, intubated in ED and transferred to ICU
Treatment
- 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 ward
- Discharged home, partially dependent
COPD, chronic obstructive pulmonary disease; ED, emergency department; ICU, intensive care unit; ED, emergency department; IV, intravenous.
Not based on a specific patient but is 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. Available at: http://www.goldcopd.org. Accessed: 28 February, 2022).
National Institute for Health and Care Excellence (NICE). Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2018). Available at: https://www.nice.org.uk/guidance/ng115/chapter/Recommendations#managing-exacerbations-of-copd. Accessed: 3 February, 2020).
Stoller JK. COPD exacerbations. In: Post TW, ed. COPD exacerbations: Management. UpToDate; 2022. Available at:
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