A 55-year-old male with a 30-pack-year smoking history and known severe COPD presents with acute worsening of his dyspnea, increased cough, and purulent sputum. His oxygen saturation is 88% on room air. Arterial blood gas reveals pH 7.28, PaCO2 68 mmHg, PaO2 55 mmHg. Which of the following is the most appropriate immediate management step?
✓ Correct Answer: Option C
The patient's ABG shows acute respiratory acidosis (pH 7.28, PaCO2 68) with hypoxemia (PaO2 55) in the setting of COPD exacerbation. NIPPV is indicated for acute hypercapnic respiratory failure in COPD to improve gas exchange and avoid intubation.