One hour after controlled oxygen, bronchodilators and corticosteroid treatment for a COPD exacerbation, an alert cooperative patient has pH 7.31 and

Question

One hour after controlled oxygen, bronchodilators and corticosteroid treatment for a COPD exacerbation, an alert cooperative patient has pH 7.31 and PaCO2 7.4 kPa. Secretions are manageable and there is no pneumothorax. What ventilatory treatment is indicated?

Accepted Answer

Start non-invasive ventilation with a documented escalation plan

Answer

Give respiratory stimulants instead of pressure support

Answer

Delay ventilatory support until a repeat gas the following morning

Answer

Continue oxygen alone until pH falls below 7.20

Answer

Intubate immediately because any PaCO2 above 6.5 kPa precludes NIV

Tuberculous pleuritis — SCE Respiratory MCQ

One hour after controlled oxygen, bronchodilators and corticosteroid treatment for a COPD exacerbation, an alert cooperative patient has pH 7.31 and PaCO2 7.4 kPa. Secretions are manageable and there is no pneumothorax. What ventilatory treatment is indicated?