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COPD Exacerbation: Advanced Management%u2022 If no response to initial treatment:%u2022 IV aminophylline%u2022 Non-invasive ventilation (NIV) if respiratory acidosis (pH 7.25-7.35)%u2022 Indications for intubation and mechanical ventilation:%u2022 NIV failure%u2022 Impaired mental status (confusion)%u2022 Respiratory arrest%u2022 High aspiration risk%u2022 GCS %u2264 8%u2022 Alternative: Transfer to ICU for closer monitoring and management
