الفهرس 
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Abstract
Chronic obstructive pulmonary disease is a common preventable disease that affects the patient mortality and morbidity.
COPD is characterized by persistent airflow limitation due to airway hyper reactivity to ward noxious gas.
Most common risk factor is tobacco smoking. COPD exacerbation is exaggeration of the patient symptoms (dyspnea, cough and sputum production).
Management of AE-COPD is through medical treatment only or combined with positive pressure ventilation.
Noninvasive ventilation recently becomes a gold standard for COPD management that improves oxygenation and ventilation and decrease work of breathing.
The aim of this study is to evaluate the influence of acid base and electrolyte on the type of treatment in patient with COPD exacerbation.
This study included 110 patients who were admitted to the chest department, Menoufia University with hypercapnic exacerbation of COPD.
All patients were subjected to full history taking, complete medical examination and thorough laboratory and radiological investigations. Then treated either medically or with NIPPV.
In this study we found a significant relation between acid base, PO2, PCO2, serum Hco3, serum urea and potassium level and need for NIPPV.
While there was no significant relation between serum Na, serum albumin and serum creatinine and the need for NIPPV.
The uses of NIPPV in AE-COPD improve the patient prognosis, relieve patient dyspnea and decrease the need for intubation.
Finally, NIPPV is a main tool for management of COPD exacerbation.