Dynamic Hyperinflation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Dynamic hyperinflation (DH) is a pathophysiological mechanism in both stable chronic obstructive pulmonary disease (COPD) and in acute exacerbation of COPD (AECOPD). However, the magnitude, severity, rate of development, clinical consequences, and management priorities differ markedly between these states. In acute exacerbations, rapid worsening of expiratory flow limitation, tachypnea, airway inflammation, and increased ventilatory drive culminate in pronounced DH leading to auto-positive end-expiratory pressure, respiratory muscle overload, and acute ventilatory failure. In this short review, we have discussed about DH during AECOPD, contrasting it with stable COPD and highlighting the implications for assessment, management, and prognosis.