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The lecture describes the mechanisms of deterioration of respiratory exchange during exacerbation of chronic obstructive pulmonary disease (COPD). It has been demonstrated that the rapid diagnosis and treatment of exacerbations is an important part of COPD management. The restriction of expiratory airflow followed by the increased dynamic pulmonary hyperinflation seems to be the most important pathophysiological mechanism in COPD exacerbation, which has catastrophic consequences for the respiratory system with respect to respiratory mechanics and gas exchange. In some patients, associated disorders of cardiopulmonary interactions also undoubtedly play an important role.