A 55-year-old man on ICU with severe COPD and cor pulmonale requires invasive ventilation. His baseline ABG (from outpatient records) shows pH 7.36, P...

Question

A 55-year-old man on ICU with severe COPD and cor pulmonale requires invasive ventilation. His baseline ABG (from outpatient records) shows pH 7.36, PaCO2 8.0 kPa, HCO3 34 mmol/L. He presents with pH 7.18, PaCO2 12.0 kPa, HCO3 34 mmol/L. After intubation, what PaCO2 should the ventilator target?

Accepted Answer

PaCO2 approximately 8.0 kPa - the patient's chronic baseline, to avoid post-hypercapnic alkalosis

Answer

PaCO2 5.3 kPa (normal)

Answer

PaCO2 12.0 kPa - maintain current level

Answer

PaCO2 3.5 kPa - hyperventilate aggressively

Answer

PaCO2 is irrelevant in COPD

uk-fficm MCQ (SBA): Chronic Hypercapnia - Ventilation Target

A 55-year-old man on ICU with severe COPD and cor pulmonale requires invasive ventilation. His baseline ABG (from outpatient records) shows pH 7.36, PaCO2 8.0 kPa, HCO3 34 mmol/L. He presents with pH 7.18, PaCO2 12.0 kPa, HCO3 34 mmol/L. After intubation, what PaCO2 should the ventilator target?