Question

A 62-year-old man with COPD presents to the ED with worsening dyspnoea and productive cough for 5 days. ABG on room air shows pH 7.30, PaCO2 60 mmHg, PaO2 50 mmHg, HCO3- 26 mmol/L. He is drowsy with use of accessory muscles. What is the most appropriate immediate ventilatory support?

Accepted Answer

Non-invasive ventilation (BiPAP) with controlled oxygen therapy

Answer

High-flow oxygen via non-rebreather mask only

Answer

Immediate intubation and invasive ventilation in all COPD exacerbations

Answer

Nasal cannula oxygen only

Answer

No oxygen to avoid worsening hypercapnia

Practice question

A 62-year-old man with COPD presents to the ED with worsening dyspnoea and productive cough for 5 days. ABG on room air shows pH 7.30, PaCO2 60 mmHg, PaO2 50 mmHg, HCO3- 26 mmol/L. He is drowsy with use of accessory muscles. What is the most appropriate immediate ventilatory support?