Nutrition for Severe COPD: 35kg, Type II Failure & Hypoproteinemia

Hi everyone,
I am looking for specialized nutritional advice for my father. We are currently implementing a high-level care plan at home, but given his extreme weight loss and complex diagnosis, I would value your collective experience.
[Patient Profile]
• Age: 57 years old.
• Weight: 35kg (Critically underweight/Cachexia).
• Diagnosis: Severe COPD, Type II Respiratory Failure (CO2 retention), Cor Pulmonale (Pulmonary Heart Disease).
• Special Condition: Right Bronchial Stenosis (narrowing) and Hypoproteinemia (Low serum albumin).
[Respiratory Support]
• Device: ResMed BiPAP (ST Mode, IPAP 15 / EPAP 4).
• Oxygen Levels: SpO2 is ~85% without support; rises to 92-93% with the ventilator.
[Current Daily Regimen]
1. Protein: Platinum Hydrolyzed Whey protein (mixed with zero-lactose milk).
2. Fats: MCT Oil (Nutiva brand, transitioning to medical-grade Lycodiet/MCT oil) to boost calories without increasing CO2 burden.
3. Heart & Inflammation: Ubiquinol (CoQ10) for heart support and High-quality Fish Oil (Omega-3).
4. Mucus & Gut: NAC (N-Acetylcysteine) effervescent tablets for mucus clearance and L-Glutamine for gut barrier repair.
5. Diet: Low-salt, small frequent meals to manage heart load and breathing.
6. Medication: Breztri Aerosphere (Budesonide/Glycopyrrolate/Formoterol Fumarate) inhaler.
[My Questions]
1. For those dealing with Hypoproteinemia and extreme weight loss (Cachexia), are there specific medical-grade formulas (e.g., Peptamen, Pulmocare, or specialized amino acids) that worked best to raise albumin levels without triggering CO2 spikes?
2. Given his Bronchial Stenosis, are there any specific tips for managing mucus or adjusting ventilator comfort during feeding?
3. How do you balance high-calorie intake while keeping the volume low to avoid pressing on the diaphragm?
Thank you for your kindness and for sharing your journey. Any insights could be life-saving for us.