A 70-year-old man with long-standing COPD is admitted to the hospital with an acute exacerbation. On

A 70-year-old man with long-standing COPD is admitted to the
hospital with an acute exacerbation. On physical examination, he is not
dehydrated and examination shows diminished breath sounds bilaterally without
wheezing. Pertinent laboratory values show a hematocrit of 54% (normal is 40%
to 47%). An arterial blood gas (ABG) analysis performed with the patient on
room air showed the following:

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PaO2 = 47 mm Hg

PCO2 = 67 mm Hg

pH = 7.30

HCO3 − = 34 mEq/L

How do you describe his current status, what do his current
laboratory values suggest about his long-term gas exchange status, and what
treatment should be considered?

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