65 year-old male with known history of COPD on nocturnal O2, pulmonary HTN, and past occupation in marble quarry presents to ED with 5 days of cough and dyspnea.
In ED, patient HR 131 and RR 28 with O2 sat in 80s on RA. VBG shows pH 7.38 and pCO2 55 mmHg
Clinical Follow Up
Following BiPAP placement in the MICU, patient’s respiratory status showed marked improvement. Final diagnosis was acute COPD exacerbation in the setting of underlying silicosis with progressive massive fibrosis.
Patient was treated with albuterol, ipratropium, and prednisone for COPD exacerbation. Patient was progressively weaned to RA while maintaining O2 sat >95% through day of discharge.