A 60-year-old man with COPD is on NIV for an acute exacerbation. IPAP 20, EPAP 6, FiO2 0.28. After 4 hours, ABG: pH 7.32, PaO2 8.0 kPa, PaCO2 7.8 kPa,...

Question

A 60-year-old man with COPD is on NIV for an acute exacerbation. IPAP 20, EPAP 6, FiO2 0.28. After 4 hours, ABG: pH 7.32, PaO2 8.0 kPa, PaCO2 7.8 kPa, HCO3 30 mmol/L. Mask fit is good, no leaks. He remains alert and cooperative. Pre-NIV pH was 7.28 and PaCO2 was 8.8 kPa. The team is concerned about progress. What is the single most useful parameter to assess whether NIV is working?

Accepted Answer

Change in pH

Answer

PaO2 improvement

Answer

Absolute PaCO2 value

Answer

Respiratory rate

Answer

Patient comfort score

uk-fficm MCQ (SBA): Acute Hypercapnic Respiratory Failure