13th January 2024

A 65-year-old man with known COPD presents with an acute exacerbation and type 2 respiratory failure.

A 65-year-old man with known COPD presents with an acute exacerbation and type 2 respiratory failure. After failure to respond to optimal medical management, he is started on NIV on a respiratory ward.

IPAP was set at 12cmH2O and EPAP at 4 cmH2O.

After 1 hour of NIV, a repeat ABG shows persistent low Po2 at 85%. Patient’s chest is not rising enough with ventilation.

What changes would you recommend in NIV settings?

Select the SINGLE most appropriate option from the list below. Select ONE option only.