Invited Review Series Introduction

The presence of acute or chronic respiratory failure is often seen and considered as a terminal phase of COPD At present, however, we do not have firm predictive parameters of mortality in COPD patients. In a review, Curtis speculated that a patient with two or more of the following characteristics has a bad prognosis in a time frame of 1 to 3 years: FEV1 <30% of predicted, oxygen dependence, one or more hospital admissions in the previous year for an acute exacerbation of COPD requiring mechanical ventilation, left heart failure or other comorbidities, weight loss or cachexia, decreased functional status, increasing dependence on others, and age >70 yrs. At this stage of the disease, it seems that no pharmacological treatment is able to influence the survival of these patients, except the use of long term oxygen therapy (LTOT) and possibly home noninvasive ventilation (NIV)