The Diversified Airway Management Model in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) - A Review

Chronic obstructive pulmonary disease (COPD) is recognized as one of the three foremost causes of mortality among populations throughout the world. For patients diagnosed with acute exacerbation of COPD (AECOPD), three core clinical features are commonly observed: bronchial spasm, mucus accumulation-induced obstruction, and insufficient compensatory function of the lungs. In clinical practice, airway management measures must abide by a core principle – prioritizing non-invasive over invasive interventions while placing respiratory muscle protection at the core – a standard developed to reduce airway irritation and alleviate related tissue injury. Current clinical practice guidelines support evidence-based pharmacological treatment for AECOPD, yet traditional single-modal intervention methods only bring about temporary symptom relief. These conventional approaches cannot fully address the disease's underlying pathological mechanisms, a limitation that often leads to gradual respiratory function decline and marked impairment of patients' overall quality of life. This review collates cutting-edge clinical studies focusing on multimodal airway management for AECOPD, aiming to break the cycle of over-reliance on single therapies by implementing standardized patient assessments and stratified interventions. Beyond this primary aim, the review also seeks to provide practical clinical care guidance for frontline clinicians, optimize patients' short- and long-term prognosis, and clarify key directions for future research on personalized treatment strategies.