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[Expert Solution]: a 64 year old, 197 lb, 6ft 1in male…

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a 64 year old, 197 lb, 6ft 1in male patient was admitted 3 days ago for a COPD exacerbation. He is currently receiving supplemental oxygen via nasal cannula at 3 L/min, albuterol and ipratropium every 4 hours, and an intravenous corticosteroid and antibiotic. he has bilaterally diminished breath sounds, with rhonchi in both bases and a weak, non productive cough. a chest x-ray from this morning shows bibasilar infiltrates. the current arterial blood gas results revel pH 7.32, PaCO2 57 mmHg, PaO2 54mm Hg, SaO2 85%, and HCO3- 29 mEq/L. how should this blood gas be interpreted? does the situation warrant intubation and mechanical ventilation? why or why not? if intubation is required, what mode and parameters would you suggest for this patient?

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