A 60-year-old male with COPD is being managed with NIV (BiPAP) for an acute exacerbation. After 30 minutes, his pH has improved from 7.25 to 7.30 and ...

Question

A 60-year-old male with COPD is being managed with NIV (BiPAP) for an acute exacerbation. After 30 minutes, his pH has improved from 7.25 to 7.30 and his PaCO2 has decreased from 9.0 kPa to 7.5 kPa. He is tolerating the mask. What does this blood gas trend indicate?

Accepted Answer

The NIV is working effectively - the improving pH and decreasing CO2 indicate a positive response; continue NIV and reassess at 1 hour

Answer

NIV has failed and the patient needs intubation

Answer

The patient has been over-ventilated and NIV should be discontinued

Answer

Blood gases should not be repeated during NIV

Answer

The improvement is too slow - intubation is needed

uk-dipimc MCQ (SBA): NIV Response Assessment

A 60-year-old male with COPD is being managed with NIV (BiPAP) for an acute exacerbation. After 30 minutes, his pH has improved from 7.25 to 7.30 and his PaCO2 has decreased from 9.0 kPa to 7.5 kPa. He is tolerating the mask. What does this blood gas trend indicate?