A 72-year-old man with COPD (FEV1 35% predicted) presents with increased dyspnoea, sputum volume, and purulence. On arrival, RR is 30 breaths/min, SpO...

Question

A 72-year-old man with COPD (FEV1 35% predicted) presents with increased dyspnoea, sputum volume, and purulence. On arrival, RR is 30 breaths/min, SpO2 84% on room air, pH 7.28, PaCO2 8.0 kPa (60 mmHg), PaO2 56 mmHg on 4 L/min nasal prongs. Which intervention is most appropriate in addition to bronchodilators, steroids, and antibiotics?

Accepted Answer

Non-invasive positive pressure ventilation (NIV) with careful monitoring

Answer

Immediate endotracheal intubation and invasive ventilation

Answer

High-flow oxygen to maintain SpO2 >98%

Answer

Discharge with oral antibiotics and close follow-up

Answer

No respiratory support beyond current oxygen therapy

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