The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has emerged due to joint efforts and support of the American National Heart, Lung & Blood Institute and the World health Organisation, with the objective of enlightening the major issues regarding COPD, and reducing the morbidity and mortality rates of this disease. An exacerbation of respiratory symptoms requiring hospital treatment is a common clinical manifestation of COPD. The exacerbation is usually induced by an infection of the tracheobronchial tree or air pollution, but in about one third of severe exacerbations the cause remains obscure. Acute COPD exacerbations are effectively treated by the application of inhalatory bronchodilators (particularly β-agonists and/or anticholinergics), teophylline and systemic, especially oral glucocorticoids. The patients with COPD exacerbation presented with the clinical symptoms of a respiratory infection (e.g. increased volume and altered colour of the sputum and/or fever) may benefit from antibiotic treatment. Non-invasive Positive Pressure Ventilation (NPPV) in acute exacerbations may improve blood gases and pH levels, reduce intrahospital mortality and the need for applying invasive mechanical ventilation and intubation, shortening thus the hospital treatment duration

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