Respiratory Failure and Non-Invasive Ventilation — Viva Defence

Opening statement (SASPOP, delivered aloud)

"Mr Webb is a 73-year-old retired carpenter with severe COPD, admitted with his second acidotic exacerbation requiring NIV this year, now recovering. His main problems are: advanced airflow obstruction with established ventilatory failure; a deteriorating exacerbation trajectory with two NIV admissions in four months; probable persistent hypercapnia needing post-discharge assessment for domiciliary NIV; the question of long-term oxygen; and the absence of any documented ceiling of care or advance care plan. I would like to complete his acute weaning safely, optimise his maintenance program, make the domiciliary decisions on evidence, and address goals of care while he is well." ^{[1] [3]}