10th September 2020

A 72-year-old patient with COPD presents to the respiratory clinic

A 72-year-old patient with COPD presents to the respiratory clinic. Despite stopping smoking 5 years ago, having optimal adherence to pulmonary rehabilitation techniques and dual LABA and LAMA therapy and no recent exacerbations, his dyspnoea has progressively worsened to the point of being unable to leave his house without becoming severely dyspnoeic. He also complains of bilateral leg swelling developing over the last 3 months. An arterial blood gas taken at the clinic reveals a PaO₂ of 7.5 kPa.

For the patient above, please select the SINGLE most appropriate intervention for their COPD. Select ONE option from the list above.