A 63-year-old patient attends the acute assessment unit with chronic shortness of breath on a background of COPD.
A 63-year-old patient attends the acute assessment unit with chronic shortness of breath on a background of COPD. He continues to be a heavy smoker. There is mild wheeze on examination of his chest, and oxygen saturations are 92% on room air.
Arterial blood gas on room air shows the following:
| Investigation | Results | Normal value |
|---|---|---|
| pH | 7.38 | 7.35-7.45 |
| pCO2 | 7.5 kPa | 4.7-6.0 kPa |
| pO2 | 8.2 kPa | >10.5 kPa |
| HCO3- | 31 mmol/l | 22-29 mmol/l |
Which of the following is the most appropriate management plan?
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