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HardEmergencyAcute COPD exacerbation with hypercapnic respiratory failureca-mccqe1ca-rcpsc-emca-rcpsc-im

A 58-year-old man with COPD exacerbation presents with RR 30, use of accessory muscles and drowsiness. ABG shows pH 7.28, PaCO₂ 8.5 kPa, PaO₂ 7.5 kPa on 28% Venturi oxygen. According to COPD and ED guidance, what is the most appropriate next step in ventilatory support?

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