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    <Journal>
      <PublisherName>jmedicalcasereports</PublisherName>
      <JournalTitle>Frontiers in Medical Case Reports</JournalTitle>
      <PISSN>I</PISSN>
      <EISSN>S</EISSN>
      <Volume-Issue>Volume 7; Issue 2</Volume-Issue>
      <PartNumber/>
      <IssueTopic>Multidisciplinary</IssueTopic>
      <IssueLanguage>English</IssueLanguage>
      <Season>(Mar-Apr, 2026)</Season>
      <SpecialIssue>N</SpecialIssue>
      <SupplementaryIssue>N</SupplementaryIssue>
      <IssueOA>Y</IssueOA>
      <PubDate>
        <Year>-0001</Year>
        <Month>11</Month>
        <Day>30</Day>
      </PubDate>
      <ArticleType>Medical Case Reports</ArticleType>
      <ArticleTitle>Acute on Chronic Hypercapnic Respiratory Failure in a Patient with Childhood Tuberculosis: A Diagnostic and Management Case Study</ArticleTitle>
      <SubTitle/>
      <ArticleLanguage>English</ArticleLanguage>
      <ArticleOA>Y</ArticleOA>
      <FirstPage>1</FirstPage>
      <LastPage>9</LastPage>
      <AuthorList>
        <Author>
          <FirstName>Mayesha</FirstName>
          <LastName>Ahmed</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>N</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Jasmine</FirstName>
          <LastName>Cha</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Michael</FirstName>
          <LastName>Pierides</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Esha</FirstName>
          <LastName>Kauravlla</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Roxana</FirstName>
          <LastName>Lazarescu</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
        </Author>
      </AuthorList>
      <DOI/>
      <Abstract>A 61-year-old female with asthma and a history of childhood tuberculosis presented to an urgent care center with 3 days of worsening dyspnea and progressed to hypercapnic respiratory failure, prompting transfer to the emergency department and initiation of Bilevel Positive Airway Pressure (BiPAP) machine. Initial arterial blood gas on presentation demonstrated pH of 7.29, pCO__ampersandsign#8322; of 70 mmHg, and HCO__ampersandsign#8323; of 33.7 mEq/L with a pO__ampersandsign#8322; of 171 mmHg on BiPAP. Imaging revealed near-complete destruction of the left lung with mediastinal shift and compensatory hyperinflation of the right lung with severe emphysema. BiPAP was discontinued due to concern for dynamic hyperinflation and barotrauma. The patient was managed with careful oxygen titration targeting SpO2 88-92%, corticosteroids, and bronchodilators, with clinical improvement and discharge on home O2 as needed. This case highlights the individualized respiratory support required in a patient with functional single-lung physiology.</Abstract>
      <AbstractLanguage>English</AbstractLanguage>
      <Keywords>Post-Tuberculosis Lung Disease (PTLD),Unilateral Lung Destruction,Hypercapnic Respiratory Failure,Dynamic Hyperinflation,Single-lung Physiology,Barotrauma Risk,Non-invasive Ventilation (NIV),Obstructive Lung Disease</Keywords>
      <URLs>
        <Abstract>https://www.jmedicalcasereports.org/ubijournal-v1copy/journals/abstract.php?article_id=16219&amp;title=Acute on Chronic Hypercapnic Respiratory Failure in a Patient with Childhood Tuberculosis: A Diagnostic and Management Case Study</Abstract>
      </URLs>
      <References>
        <ReferencesarticleTitle>References</ReferencesarticleTitle>
        <ReferencesfirstPage>16</ReferencesfirstPage>
        <ReferenceslastPage>19</ReferenceslastPage>
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