A 72-Year-Old Patient with COPD Who Has Acute-On-Chronic Respiratory Failure

A 72-year-old patient with COPD who has acute-on-chronic respiratory failure is supported with noninvasive ventilation. The patient is becoming more confused. Blood gas values are as follows: PaO₂ = 46 mm Hg, PaCO₂ = 57 mm Hg, pH = 7.22, and HCO₃⁻ = 22 mEq/L. Which of the following would be appropriate treatment for this patient?

A) Increase oxygen delivery.
B) Ask the patient if he is comfortable with the mask.
C) Ask the physician for a sedative.
D) Intubate and switch to invasive ventilation.

Correct Answer:

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