Respiratory Failure

Question 1

How many types of respiratory failure?

Answer 1

Type 1

Type 2

Question 2

Describe Type 1

Answer 2

Hypoxaemic
Low Blood O2
PaO2 < 8kPa
(60mm/Hg)

Question 3

Describe type 2

Answer 3

Hypercapnic
High blood Co2
PaCO2 > 6kPa 
(45mm/Hg)
Plus low O2

Question 4

Causes of Type 1

Answer 4

Pneumonia, COPD, Pulmonary Oedema

Impaired gas exchange due to impaired diffusion

Question 5

Causes of Type 2

Answer 5

COPD, Severe Asthma, Myasthenia Gravis, Poisoning

Question 6

Presenting Signs and Symptoms

Answer 6

• SOB
• Syncope
• Use of accessory muscles
• Pursed lip breathing
• Cyanosis
• Peripheral/ central Cyanosis
• Tachycardia
• Confusion
• Arrhythmia
• Orthopnoea

Question 7

Investigations

Answer 7

• CXR
• ECG
• FBC
• PFT
• SPIROMETRY
• Renal function
• LFT
• TFT
• ECHO

Question 8

Why a FBC?

Answer 8

To check for polycythaemia or anaemia

Question 9

Why do TFT?

Answer 9

Thyroid function may cause abnormal respiration

Question 10

LFT?

Answer 10

Show any abnormal levels of electrolytes which aggravate respiratory failure.

Question 11

What about previous MI?

Answer 11

Do cardiac troponin test and creatine kinase.

Question 12

Treatment for Respiratory Failure?

Answer 12

Give O2 to bring back to >90% saturation
Mechanical Ventilation
NIV- non invasive ventilation

Question 13

What is a danger with giving oxygen?

Answer 13

If the patients are on hypoxic drive then they giving O2 can suppress their respiratory drive completely.

Question 14

What other condition is associated with Hypercapnea?

Answer 14

Respiratory Acidosis

Question 15

What pulmonary vascular disease can lead to Respiratory Failure?

Answer 15

Pulmonary Hypertension

• Leads to hypoxic Cor Pulmonale
• Right heart failure.