Question

A 69-year-old woman with COPD exacerbation and pH 7.26 refuses NIV. After discussion, NIV is attempted and fails. She is somnolent with rising PaCO₂. Next step?

Accepted Answer

Endotracheal intubation and mechanical ventilation

Answer

NIV is attempted and fails. She is somnolent with rising PaCO₂. Next step?

Answer

Continue NIV despite worsening

Answer

High-flow nasal cannula only

Answer

No ventilatory support

Practice question

A 69-year-old woman with COPD exacerbation and pH 7.26 refuses NIV. After discussion, NIV is attempted and fails. She is somnolent with rising PaCO₂. Next step?