ModerateRespiratoryCOPD exacerbation with type 2 respiratory failureuk-plab-1
A 45-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents with 2 days of increased breathlessness, purulent sputum and wheeze. On room air his oxygen saturation is 86%, respiratory rate 24/min, and he is using accessory muscles. An arterial blood gas on 28% Venturi oxygen shows: pH 7.32, PaCO₂ 7.0 kPa, PaO₂ 7.8 kPa, HCO₃⁻ 30 mmol/L. What is the single best initial oxygen strategy?