A 58-year-old man with chronic obstructive pulmonary disease is admitted with an acute exacerbation and hypercapnic respiratory failure (pH 7.25, PaCO...

Question

A 58-year-old man with chronic obstructive pulmonary disease is admitted with an acute exacerbation and hypercapnic respiratory failure (pH 7.25, PaCO₂ 70 mm Hg). He is drowsy but arousable. What is the most appropriate initial ventilatory support?

Accepted Answer

Trial of non-invasive positive pressure ventilation if no contraindications

Answer

Immediate endotracheal intubation and invasive ventilation

Answer

High-flow nasal oxygen only

Answer

Simple nasal prongs at 2 L/min

Answer

Heliox therapy only

ca-mccqe1 MCQ (SBA): Acute hypercapnic COPD exacerbation

A 58-year-old man with chronic obstructive pulmonary disease is admitted with an acute exacerbation and hypercapnic respiratory failure (pH 7.25, PaCO₂ 70 mm Hg). He is drowsy but arousable. What is the most appropriate initial ventilatory support?