A 65-year-old man presented to emergency department with acute exacerbation of COPD. ABG showed hypercapnic respiratory failure with pH 7.28, PaCO2 65 mmHg, bicarbonate 27 mmol/L. Which of the following is the most appropriate noninvasive ventilatory support?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Bilevel positive airway pressure (BiPAP)
pH 7.28 with PaCO₂ 65 is acute hypercapnic respiratory failure in an AECOPD (pH ≤7.35, PaCO₂ ≥45). That is an indication for NIPPV, and BiPAP is the mode most commonly used. BiPAP gives inspiratory support that boosts ventilation and clears CO₂. CPAP gives only basal end-expiratory support, so it is less suitable. High-flow nasal cannula and room air do not provide ventilatory support.
ليش كل خيار صح أو غلط
-
A
ليش صح
BiPAP is the NIPPV mode most commonly used in AECOPD; it gives inspiratory support, which helps ventilation in respiratory muscle fatigue and hypercapnia.
✓ COPD.pdf · p. 12 -
B
ليش غلط
CPAP only provides basal end-expiratory support, with no inspiratory support, so it is less suitable than BiPAP here.
✓ COPD.pdf · p. 12 -
C
ليش غلط
HFNC improves oxygenation; the device that improves CO2 clearance and work of breathing is BiPAP, which is what hypercapnic failure needs.
✓ 11• Respiratory Failure [Notes].pdf · p. 7 -
D
ليش غلط
pH 7.28 with PaCO2 65 meets the indication for NIPPV (pH ≤ 7.35, PaCO2 ≥ 45), the preferred strategy for acidosis in AECOPD; room air gives no ventilatory support.
✓ COPD.pdf · p. 11
- المصدر
- COPD.pdf · p. 11
COPD.pdf · p. 12 - المحاضرة
- COPD Exacerbation · Pulmonology · Module B
- ظهر في
- MED43 ♂ Quiz B