Wednesday, September 8, 2021

COPD - life-threatening

 Q: 58 years old male with COPD exacerbation is admitted to ICU with respiratory rate of more than 30 breaths per minute. His oxygen saturation is 88% on a 35% Venturi mask (VM). ABG showed PCO2 of 58 mmHg. Which of the following will make it a life-threatening respiratory failure? (select one) 

A) use of accessory muscles 

B) acute mental status change


Answer:

As per Global Initiative for Chronic Obstructive Lung Disease (GOLD), COPD patients who require hospitalization are classified into three categories

  • No respiratory failure 
  • Acute nonlife-threatening respiratory failure
  • Acute life-threatening respiratory failure

Contrary to popular belief, the use of accessory muscles of respiration is common and can be supported with non-invasive or invasive mechanical ventilation. Acute change in mental status, high oxygen requirement, severe hypercarbia or pH less than 7.25 makes it life-threatening.

#pulmonary


Reference:

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease: 2020 Report. http://www.goldcopd.org (Accessed on August 29, 2021).

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