A 52-year-old man with chronic obstructive pulmonary disease (COPD) is admitted with an acute exacerbation. Arterial blood gas shows: pH 7.28, PaCO₂ 62 mmHg, HCO₃⁻ 28 mEq/L, PaO₂ 55 mmHg. His hemoglobin is 16.5 g/dL (secondary polycythemia). Body temperature is 38.5°C. Which combination of factors is shifting his oxygen-hemoglobin dissociation curve to the RIGHT, and what is the physiological consequence?

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