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MediumRespiratoryAcute hypercapnic COPD exacerbationca-mccqe1ca-rcpsc-em

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?

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