Question

A 60-year-old man with COPD develops an acute exacerbation with PaCO2 60 mmHg and pH 7.30 on arterial blood gas despite optimal medical therapy and controlled oxygen. He is drowsy but arousable. What is the MOST appropriate next step?

Accepted Answer

Start non-invasive ventilation with close monitoring

Answer

Intubate and ventilate immediately in all COPD exacerbations

Answer

Stop all oxygen therapy

Answer

Give only additional bronchodilators and observe

Answer

Discharge with oral steroids and antibiotics

Practice question

A 60-year-old man with COPD develops an acute exacerbation with PaCO2 60 mmHg and pH 7.30 on arterial blood gas despite optimal medical therapy and controlled oxygen. He is drowsy but arousable. What is the MOST appropriate next step?