However, NIMV failure can occur due to various factors, including the underlying cause of ARF. While the lactate/albumin ratio (LAR) has been studied as a prognostic biomarker in various critical conditions, this study is the first to specifically evaluate its role in predicting NIMV failure in patients with acute hypercapnic respiratory failure due to COPD exacerbation. Here, ALB is linked to chronic obstructive pulmonary disease.