Respiratory failure

Question 1

What organization published guidelines on non-invasive ventilation in 2002?

Answer 1

The British Thoracic Society (BTS) published guidelines on non-invasive ventilation in 2002.

Question 2

What organization published guidelines on non-invasive ventilation in 2008?

Answer 2

The Royal College of Physicians published guidelines on non-invasive ventilation in 2008.

Question 3

What are the key indications for non-invasive ventilation?

Answer 3

1. COPD with respiratory acidosis (pH 7.25-7.35)
2. Type II respiratory failure secondary to chest wall deformity, neuromuscular disease, or obstructive sleep apnoea
3. Cardiogenic pulmonary oedema unresponsive to CPAP
4. Weaning from tracheal intubation

Question 4

What is the recommended Expiratory Positive Airway Pressure (EPAP) for COPD?

Answer 4

4-5 cm H2O

Question 5

What is the recommended Inspiratory Positive Airway Pressure (IPAP) for COPD according to RCP?

Answer 5

10 cm H2O

BTS suggests 12-15 cm H2O.

Question 6

What is the recommended back up rate for non-invasive ventilation?

Answer 6

15 breaths/min

Question 7

What is the recommended back up inspiration:expiration ratio for non-invasive ventilation?

Answer 7

1:3

Question 8

What organization published guidelines on non-invasive ventilation in 2002?

Answer 8

The British Thoracic Society (BTS) published guidelines on non-invasive ventilation in 2002.

Question 9

What organization published guidelines on non-invasive ventilation in 2008?

Answer 9

The Royal College of Physicians published guidelines on non-invasive ventilation in 2008.

Question 10

What are the key indications for non-invasive ventilation?

Answer 10

1. COPD with respiratory acidosis (pH 7.25-7.35)
2. Type II respiratory failure secondary to chest wall deformity, neuromuscular disease, or obstructive sleep apnoea
3. Cardiogenic pulmonary oedema unresponsive to CPAP
4. Weaning from tracheal intubation

Question 11

What is the recommended Expiratory Positive Airway Pressure (EPAP) for COPD?

Answer 11

4-5 cm H2O

Question 12

What is the recommended Inspiratory Positive Airway Pressure (IPAP) for COPD according to RCP?

Answer 12

10 cm H2O

BTS suggests 12-15 cm H2O.

Question 13

What is the recommended back up rate for non-invasive ventilation?

Answer 13

15 breaths/min

Question 14

What is the recommended back up inspiration:expiration ratio for non-invasive ventilation?

Answer 14

1:3

Question 15

What is respiratory failure?

Answer 15

Respiratory failure describes the inability of the respiratory system to maintain adequate gas exchange.

Question 16

What are the two main types of respiratory failure?

Answer 16

Type 1: ↓ pO2 with a normal or ↓ pCO2
Type 2: ↑ pCO2 with a normal or ↓ pO2

Question 17

What is hypercapnia and its effect on pH?

Answer 17

Hypercapnia leads to ↓ pH, resulting in respiratory acidosis.

Question 18

What are the causes of type 1 respiratory failure?

Answer 18

Causes include pneumonia, pulmonary embolism, asthma, pulmonary oedema, and acute respiratory distress syndrome.

Question 19

What are the causes of type 2 respiratory failure?

Answer 19

Causes include chronic obstructive pulmonary disease, decompensation in other respiratory conditions (e.g., life-threatening asthma, pulmonary oedema), neuromuscular disease, obesity hypoventilation syndrome, and sedative drugs (e.g., benzodiazepines, opiate overdose).