skip to main content

COPD exacerbation — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardCOPDCOPD exacerbationSCE Respiratory

A 73-year-old woman with severe COPD presents with increasing sputum and drowsiness. She has received controlled oxygen, nebulised bronchodilators, steroids and antibiotics. ABG on 28% Venturi: pH 7.26, PaCO2 9.4 kPa, PaO2 8.1 kPa, HCO3 32 mmol/L. What is the most appropriate ventilation strategy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Acute NIV with target oxygen saturation 88-92%

Acute hypercapnic respiratory failure with respiratory acidosis in COPD is an indication for NIV alongside controlled oxygen. High-flow oxygen risks worsening hypercapnia in CO2 retainers, and nebulisers alone do not address ventilatory failure. Invasive ventilation is considered if NIV is contraindicated, fails or the patient cannot protect the airway.

Reference: BTS/ICS Guideline for Acute Hypercapnic Respiratory Failure 2016; NICE NG115