SAQ 1458 – COPD exacerbation not improving on NIV

A 75-year-old man is brought to your ED with severe shortness of breath. You assess him as having an infective exacerbation of COPD and are considering non-invasive ventilation.

After one hour of bi-level NIV, the following arterial blood gas is taken. It is very similar to the blood gas performed on arrival.

Parameter	Result	Reference range
FiO2	0.5
pH	7.26	7.35-7.45
pCO2	86 mmHg	35-45 mmHg
pO2	52 mmHg	60-100 mmHg
HCO3	38 mmol/L	24-34 mmol/L
BE	7.1 mmol/L	-3 to 3 mmol/L

List four contraindications to NIV for COPD in the ED.

(Marked out of 2.0)

/ 2

List the pathological processes evident on the arterial blood gas, with supporting evidence.

(Marked out of 4.0)

/ 4

List the changes you would make to his NIV parameters because of these findings.

(Marked out of 2.0)

/ 2

Total Score: 0 / 8

Percentage: 0%