Lungs: Respiratory Failure T1, T2

Question 1

T1RF

• diagnosis
• causes

Answer 1

PO2 U8kPa
CO2 normal/low
HYPOXIA - IMPAIRED GAS EXCHANGE

Detected by SaO2

VQ mismatch, low PiO2, alveolar hypoventilation
Pulmonary edema, fibrosis
Pneumonia
Atlectasis, pneumothorax
Asthma, COPD

Question 2

T2RF

• diagnosis
• causes

Answer 2

PO2 8kPa+
PCO2 6kPa+
HYPOXIA + HYPERCAPNIA - PUMP FAILURE

Detected by ABG

Low neural drive
-polio, MND, SC injury, GBS, MG, encephalitis
-opiates
Low muscle capacity
-DMD, BMD
Increased resp load
-kyphoscoliosis, obesity, COPD

Question 3

Presentation

• acute
• chronic

Answer 3

SOB
Cyanosed, sleepy
Confused

SOB
Sleep disordered breathing
End organ injury

Question 4

Management of T1RF

Answer 4

O2 if hypoxic

• 15L NRM - 94-98%
• Venturi mask - 88-92% CO2 retainer

If no improvement => CPAP (NIV)

Question 5

Management of T2RF

Answer 5

If low ventilation rate and starting to tire => BIPAP (NIV) get rid of excess CO2

• no sedation
• not invasive

Invasive - needs sedation (tracheal intubation)

• LOC, resp/cardiac instability
• cannot protect airway, confused
• BUT NOT APPROPRIATE FOR ALL