You are asked to review a 74-year-old female in the Emergency Department who has presented with an infective exacerbation of her Chronic Obstructive Pulmonary Disease (COPD).
On examination she is conscious, but unable to speak in sentences. She has a respiratory rate of 36 breaths/min and oxygen saturations of 88% on high flow nasal prongs (HFNP) with FiO2 = 0.4, and 50 L/min of flow. Heart rate is 108 beats/min and blood pressure 156/84 mmHg.
Her blood gas shows:
PaO2 58 mmHg (7.73 kPa)
CO2 52 mmHg (6.93 kPa)
Lactate 3.2 mmol/L
What factors would influence your decision to choose non-invasive ventilation or invasive ventilation in this patient?
Suitability for intubation:
Factors which favour a beneficial effect from invasive ventilation:
Factors which predict a poor outcome from intubation:
Patient and family preferences
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