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Acute hypercapnic respiratory failure — MCCQE Part 1 MCQ

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ModerateDyspneaAcute hypercapnic respiratory failureMCCQE Part 1

A 65-year-old man with COPD on home O2 presents confused, drowsy. ABG: pH 7.25, pCO2 80, pO2 55 on 4L NC. Which is the most appropriate ventilatory intervention?

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Correct answer: D — Non-invasive positive pressure ventilation (BiPAP)

Acute hypercapnic respiratory failure in COPD: NIV (BiPAP) first-line. Reduces intubation and mortality. Contraindications: facial trauma, vomiting, GCS <8. If NIV fails, intubate.

Reference: CTS COPD / NIV Guidelines