1st April 2022

Julian is a 58-year-old man with severe chronic obstructive pulmonary disease (COPD)

Julian is a 58-year-old man with severe chronic obstructive pulmonary disease (COPD). His FEV₁ is 18% of predicted despite maximal medical therapy. He has been hospitalised with acute exacerbations of COPD 4 times over the past 6 months. He has significant ankle oedema and an enlarged right ventricle on his most recent echo. What management option should be discussed with Julian?

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