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: B
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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