Question

A 63-year-old with severe COPD is admitted with worsening dyspnea and pCO₂ 58 mmHg with acidosis. After bronchodilators and steroids, he remains hypercapnic with respiratory distress. Next step?

Accepted Answer

Initiate noninvasive ventilation (NIV)

Answer

Intubate immediately without NIV trial

Answer

Add antibiotics only

Answer

Start acetazolamide

Answer

High-dose diuretics

Practice question

A 63-year-old with severe COPD is admitted with worsening dyspnea and pCO₂ 58 mmHg with acidosis. After bronchodilators and steroids, he remains hypercapnic with respiratory distress. Next step?