Question

A 59-year-old with COPD presents with acute exacerbation and hypercapnia. pH 7.28, PaCO₂ 64 mm Hg, RR 30, using accessory muscles, persistent hypoxia on supplemental O₂. Best next step?

Accepted Answer

Trial of noninvasive ventilation (NIV)

Answer

Immediate endotracheal intubation

Answer

Heliox therapy only

Answer

Increase oxygen to SpO₂ 100%

Answer

Diuretics

Practice question

A 59-year-old with COPD presents with acute exacerbation and hypercapnia. pH 7.28, PaCO₂ 64 mm Hg, RR 30, using accessory muscles, persistent hypoxia on supplemental O₂. Best next step?