A 70-year-old man with long-standing COPD presents with somnolence and a PaCO₂ of 70 mm Hg on arterial blood gas during an exacerbation. pH is 7.28. A...

Question

A 70-year-old man with long-standing COPD presents with somnolence and a PaCO₂ of 70 mm Hg on arterial blood gas during an exacerbation. pH is 7.28. After initial bronchodilators and oxygen titration, he remains hypercapnic with increased work of breathing. According to CTS guidance, what is the next best step?

Accepted Answer

Initiate non-invasive ventilation (BiPAP) if there are no contraindications

Answer

Increase oxygen to maintain SpO₂ 100%

Answer

Intubate immediately without trying non-invasive ventilation

Answer

Discharge home with increased inhalers

Answer

Start diuretics only

ca-mccqe1 MCQ (SBA): COPD exacerbation with hypercapnic respiratory failure