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HardEmergencyAcute hypercapnic respiratory failure in COPDau-acemau-racpau-amc

A 65-year-old woman with COPD and long smoking history presents with worsening somnolence and headache. ABG on 2 L/min oxygen shows pH 7.25, PaCO₂ 70 mmHg, PaO₂ 55 mmHg. What is the most appropriate immediate management?

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