HardRespiratory MedicineAcute Exacerbation of COPD with Respiratory Failuremrcem sbaukmlamrcp part 1
A 70-year-old man with a history of COPD presents to the Emergency Department with increased shortness of breath, wheeze, and increased sputum purulence over the past 3 days. His oxygen saturation is 89% on 2L/min nasal cannula (his usual home oxygen rate). He is alert. His respiratory rate is 26/min. An ABG on 2L/min oxygen shows pH 7.32, PaCO2 7.8 kPa, PaO2 8.0 kPa, HCO3 30 mmol/L. What is the most appropriate initial management of his respiratory failure?