Chronic obstructive pulmonary disease (COPD) significantly reduces quality of life and is one of the main causes of chronic morbidity and mortality worldwide. Acute exacerbation of COPD (AECOPD) is a life-threatening condition that causes rapid deterioration of respiratory symptoms (worsening of dyspnea, cough and/or abundant sputum production) requiring urgent treatment. This review article examines the evidence underlying supplemental oxygen therapy and ventilator support during exacerbations of COPD. In the introduction, we discuss the epidemiology and pathophysiology of hypercapnic respiratory failure, and then we explain that the key to achieving appropriate levels of oxygenation is using controlled low-flow oxygen therapy. In patients with risk of hypercapnia a target oxygen saturation (SaO ) range of 88%–92% 2 is now generally accepted unless hypercapnia is disproved by gas analysis of arterial blood. However, if the partial pressure of carbon dioxide in arterial blood (PaCO ) is normal, oxygen therapy may target the usual saturation range of 94%–98%. 2 Many COPD patients may have a lower stable SaO , such that chasing this target (94%-98%) is not usually necessary unless 2 the patient is unwell. Further, we review current recommendations for ventilatory support in patients with AEHOBP. Noninvasive ventilation has assumed an important role in managing patients with acute respiratory failure. The use of invasive ventilation is the last remaining option, associated with a poor outcome.

The urgent surgery center “Simonida” in Gra~anica was built by humanitarian organization “Doctors of the World” from Greece with donation of Ministry of Foreign affairs of Greece and Greek institute for mother and child. He started working in march 2000. Even though, it has a small capacity of 15 beds, it represent a very important part in health care for the people Serbian enclaves in Kosovo and Metohia. During 2002. 15133 patients were examined in this hospitaly. 811 patient were hospitalized, and 98 of them were operated. Serbian doctors performed the firs surgery 11.07.2002. when the patient S.S. 46 years old was operated due to inguinal hernia on left side. In the urgent surgery center 72 (73,47%) male patients and 26 (26,53%) female patients. Were operated 64 (65,31%) adults patients and 34 (34,69%) children were operated. In this hospital 46 patients for inguinal hernia, 14 patients for acuta appendicitis, 8 for inflammation of gall, 4 for testis retency, 4 for pilonoidal sinus, 3 for higrom, and 22 patients with other diseased were operated. Total anestesy used with 68 (69,63%), spinalis with 22 (22,45%) and local with 8 (8,16%) patients. Total anestesy was used with 36 adulta patients and with 32 children patients. Considering the restricted freedom of moveing and bad security situation of people in enclaves, the urgent surgery center “Simonida” justify its egzistence making possible adequate surgery help to the suftering peoples of Central Kosovo, Sirini} region and region Kosovsko Pomoravlje.