Resp failure

Question 1

Respiratory failure T1?

Answer 1

low o2 (<8 KPa) 
low co2 (<6)

Question 2

Respiratory failure T2?

Answer 2

low o2 (<8 KPa) 
high co2 (>6 KPa)

Question 3

Causes of Resp failure?

Answer 3

V/Q mismatch
Alveolar hypoventilation
Diffusion failure

Question 4

Causes of T1 resp failure?

Answer 4

V/Q mismatch and diffusion failure

Question 5

Causes of T2 resp failure?

Answer 5

Alveolar hypoventilation ± V/Q mismatch

Question 6

Causes of V/Q mismatch?

Answer 6

Vascular: PE, Pulmonary shunt

Resp: Asthma. Pneumothorax, atelectasis

Question 7

Causes of alveolar hypoventilation?

Answer 7

Obstructive

Restrictive

Question 8

Obstructive causes of alveolar hypoventilation?

Answer 8

COPD
Asthma
Bronchiectasis

Question 9

Restrictive causes of alveolar hypoventilation

Answer 9

Reduced drive (CNS sedation/tumour)
Obesity
Fluid and fibrosis

Question 10

Causes of diffusion failure?

Answer 10

Fluids: oedema, pneumonia, infarction, blood

Blood

Question 11

Chronic sx of resp failure?

Answer 11

polycythaemia

cor pulmonale

Question 12

Sx of hypercapnoea

Answer 12

Headache
Flushing and peripheral vasodilation
Bounding pulse
Flap
Confusion --> coma

Question 13

Rx for T1 resp failure?

Answer 13

• Mx cause
• o2 (SpO2 94-98%)
• Assisted ventilation if PaO2 <8KPa despite o2

Question 14

Rx for T2 resp failure?

Answer 14

Mx cause

24% O2 (SpO2 88-92%)

Check ABG after 20mins:
- If PaCO2 steady or lower can ↑ FiO2 if necessary
- If PaCO2 ↑>1.5KPa and pt. still hypoxic, consider
NIV or respiratory stimulant (e.g. doxapram)