A 72-year-old woman with COPD presents with increasing dyspnoea and hypercapnic respiratory failure despite optimal medical therapy. She is drowsy wit...

Question

A 72-year-old woman with COPD presents with increasing dyspnoea and hypercapnic respiratory failure despite optimal medical therapy. She is drowsy with pH 7.25 and PaCO₂ 8.5 kPa but haemodynamically stable. According to CTS COPD guidance, what is the most appropriate next step?

Accepted Answer

Trial non-invasive ventilation with close monitoring

Answer

Intubate immediately without trial of non-invasive ventilation

Answer

Give high-dose opioids to treat dyspnoea

Answer

Switch to salbutamol nebulisers only

Answer

Discharge with increased inhalers

ca-mccqe1 MCQ (SBA): Acute COPD exacerbation with hypercapnic respiratory failure

A 72-year-old woman with COPD presents with increasing dyspnoea and hypercapnic respiratory failure despite optimal medical therapy. She is drowsy with pH 7.25 and PaCO₂ 8.5 kPa but haemodynamically stable. According to CTS COPD guidance, what is the most appropriate next step?