This clinical trial is focused on studying the treatment of Chronic Obstructive Pulmonary Disease (COPD), specifically during an acute worsening of symptoms known as an acute exacerbation. The study aims to compare two different approaches to oxygen therapy provided before reaching the hospital. The treatments being tested include standard oxygen therapy and a more targeted approach where the amount of oxygen is carefully adjusted. The main goal is to find out if the targeted oxygen therapy can reduce the risk of death within 30 days compared to the standard method.

Participants in the study will receive one of the treatments through inhalation. The medications involved in the trial include Salbutamol, a solution used in nebulizers to help open the airways, and Berodual, which contains a combination of two substances, Fenoterol Hydrobromide and Ipratropium Bromide, also used to ease breathing. Additionally, Conoxia, a compressed medicinal gas containing pure Oxygen, and Airapy, a compressed medicinal gas, are part of the study. These treatments are administered to help manage breathing difficulties associated with COPD.

The study will monitor participants over a period to assess various outcomes, including the length of hospital stay, the need for intensive care, and the requirement for additional breathing support. The trial will also evaluate how patients feel in terms of breathlessness and other related symptoms. The study is expected to continue until 2026, with the aim of improving the understanding and management of COPD during acute episodes.