Respiratory failure: type 1, type 2

Question 1

Define respiratory failure?

Answer 1

Decrease in partial pressure of oxygen in the blood due to inadequate ventilation or poor perfusion.

Question 2

Define type 1 respiratory failure?

Answer 2

PaLow PaO2 (<8kPa)

+/- low PaCO2

Caused by:
Decreased atmospheric pressure
Ventilation-perfusion mismatch
Shunt
Pneumonia
ARDS
PE

Question 3

Presentation of type 1 respiratory failure?

Answer 3

Tachypnoea
Dyspnoea
Tachycardia
Confusion
Cyanosis

Question 4

Diagnosis/IVx of type 1 respiratory failure?

Answer 4

Ventilation-perfusion mismatch

Question 5

Management of type 1 respiratory failure?

Answer 5

High flow oxygen
(if not effective, do continuous positive airway pressure (CPAP) ventilation)

Treat underlying cause as well.

Question 6

Define/causes of type 2 respiratory failure?

Answer 6

Aka hypercapnic respiratory failure.

PaCO2 is >6kPa (HIGH)
PaO2 is <8kPa (LOW)

Question 7

Presentation of type 2 respiratory failure?

Answer 7

Headache
Altered behaviour
Altered level of consciousness
Papilloedema
Warm extremities
Asterixis

Question 8

Diagnosis/IVx of type 2 respiratory failure?

Answer 8

ABG
Pulse oximetry
Simple spirometry (measure tidal volume and vital capcity)
ECG (look for cardiac arrhythmias secondary to hypoxaemia)

Question 9

Management of type 2 respiratory failure?

Answer 9

Supplemental oxygen via a nasal canula, a face mask, a venturi mask or a non-rebreather mask.

Non-invasive ventilation:
- Continuous Positive Airway Pressure (CPAP) ventilation
or
- Bilevel Positive Airway Pressure (BiPAP) ventilation

Invasive ventilation:
- endotracheal tube
- tracheostomy