Personalized Therapies For Chronic Obstructive Pulmonary Disease (Copd) And Acute Respiratory Failure In Mechanically Ventilated Patients.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease associated with high morbidity and mortality, especially in acute exacerbations that require admission to the Intensive Care Unit (ICU) and invasive ventilatory support. Considering the pathophysiological complexity of COPD, standardized therapies are not always effective and individualized management is necessary. This study aimed to critically analyze the available evidence on personalized therapies in COPD patients under mechanical ventilation. Specifically, it sought to identify ventilatory adjustments and individualized pharmacological interventions, as well as to assess their impact on clinical outcomes.This is a systematic review of the literature carried out in five databases, including studies published between 2013 and 2024 that addressed personalized therapies in COPD under invasive mechanical ventilation. Studies focusing exclusively on non-invasive ventilation or case reports were excluded. The results show that detailed physiological assessment, using tools such as electrical impedance tomography and esophageal catheter, allows for personalized titration of parameters such as PEEP and ΔP. In addition, pharmacotherapy adjusted to inflammatory phenotypes and clinical condition showed a reduction in ventilation time, a higher rate of successful weaning and lower hospital mortality. It is concluded that personalization of ventilatory and pharmacological therapy in COPD patients in the ICU contributes to more favourable outcomes, reinforcing the need to incorporate strategies based on physiology and individual variability into intensive care practice. Keywords : Chronic Obstructive Pulmonary Disease; Mechanical Ventilation; Intensive Care Unit; Ventilatory Weaning.