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 T1 resp failure?

Answer 3

V/Q mismatch and diffusion failure

Question 4

Causes of T2 resp failure?

Answer 4

Alveolar hypoventilation ± V/Q mismatch

Question 5

Causes of V/Q mismatch?

Answer 5

Vascular: PE, Pulmonary shunt

Resp: Asthma. Pneumothorax, atelectasis

Question 6

Causes of alveolar hypoventilation?

Answer 6

Obstructive

Restrictive

Question 7

Obstructive causes of alveolar hypoventilation?

Answer 7

COPD

Asthma

Bronchiectasis

Question 8

Restrictive causes of alveolar hypoventilation

Answer 8

Reduced drive (CNS sedation/tumour)

Obesity

Fluid

Fibrosis

Question 9

Causes of diffusion failure?

Answer 9

Fluids: oedema,

pneumonia,

infarction,

blood

Question 10

Chronic sx of resp failure?

Answer 10

polycythaemia

cor pulmonale

Question 11

Sx of hypercapnoea

Answer 11

Headache

Flushing and peripheral vasodilation

Bounding pulse

Flap

Confusion –> coma

Question 12

Rx for T1 resp failure?

Answer 12

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

Question 13

Rx for T2 resp failure?

Answer 13

Mx cause24% 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)