HardRespiratoryCOPD exacerbation with hypercapnic respiratory failureca-mccqe1ca-rcpsc-em
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?