Invasive ventilation for COPD patients

Implications of prognostic pessimism in patients with chronic obstructive pulmonary disease (COPD) or asthma admitted to intensive care in the UK within the COPD and asthma outcome study (CAOS): multicentre observational cohort study. Wildman et el. BMJ December 2007.

I think this paper has raised the profile of whether or not to invasively ventilate patients with an exacerbation of COPD. However the paper only includes the prognosis of patients actually admitted to critical care. This means that the pessimisim in these patients was not great enough for them not to be addmitted at all. Whilst a randomised trial including all patients with an exacerbation would be unethical this is a problem with the study.

Dr. Hina Pattani