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Kyphoscoliosis-related hypoventilation — SCE Respiratory MCQ

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ModerateRespiratory Failure/NIVKyphoscoliosis-related hypoventilationSCE Respiratory

A 64-year-old man with kyphoscoliosis presents with morning headaches and somnolence. ABG on air shows pH 7.36, PaCO2 7.4 kPa, PaO2 8.2 kPa and HCO3- 34 mmol/L. Overnight oximetry shows sustained desaturation with transcutaneous CO2 rise. What is the most appropriate ventilation strategy?

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Correct answer: B — Nocturnal non-invasive ventilation

Chronic hypercapnic ventilatory failure due to chest wall disease is treated with nocturnal NIV. CPAP may splint the upper airway but does not provide adequate ventilation for hypoventilation. Oxygen alone can worsen CO2 retention and does not correct ventilatory failure.

Reference: BTS/ICS Acute Hypercapnic Respiratory Failure Guideline; NICE NG202 principles