A retrospective study analyzed the effectiveness of sequential mechanical ventilation in 125 patients with acute exacerbation of COPD (AECHOCP) and respiratory failure. After treatment, PaO2, FVC, PEF, and FEV1 improved, while PaCO2, HR, and RR decreased. Treatment was unsuccessful in 30 patients. Risk factors for treatment failure included age ≥ 60 years, presence of comorbidities, and higher APACHE II score (≥ 19). Other risk factors were PaO2 < 55 mmHg and PaCO2 ≥ 75 mmHg. Sequential ventilation has shown improvement in blood gases, lung function and stabilization of vital signs. ROC curve analysis confirmed the good predictive ability of the model for treatment failure.