The use of a ventilator is useful in acute exacerbations of chronic obstructive pulmonary disease combined with respiratory failure. Using a ventilator means performing mechanical ventilation, which is categorized into invasive and non-invasive mechanical ventilation. Chronic obstructive pulmonary disease (COPD) is a chronic airway disease with persistent airflow limitation and airway obstruction. Early symptoms are mainly chronic cough and sputum, and as the disease progresses, dyspnea is the main manifestation in the later stages. Acute exacerbation of severe chronic obstructive pulmonary disease may cause hypoxia and acid-base balance disorder in the body due to respiratory failure, and psychoneurological symptoms such as drowsiness and trance may occur. Non-invasive mechanical ventilation is the preferred respiratory treatment for acute exacerbation of COPD combined with respiratory failure, which can improve respiratory acidosis, reduce partial pressure of carbon dioxide, slow down respiratory rate, and alleviate respiratory distress. And it can avoid the airway damage caused by tracheal intubation. If the patient’s respiratory failure is still progressive, life-threatening acid-base imbalance and altered consciousness, invasive mechanical ventilation can be used.