chronic ventilatory failure

Question 1

what is type l ventilatory failure?

Answer 1

Hypoxic and low pCO2

Question 2

What is type ll ventilatory failure?

Answer 2

Elevated PCO2 (6.0 kPA)

Normal blood pH

low pO2 <8 kPA

elevated bicarbonate (HCO3)

Question 3

What are the causes of chronic ventilatory failure?

Answer 3

Airways disease
- COPD
- bronchiectasis

Chest abnormalities
- kyphoscoliosis

central hypoventilation
- obesity hypoventilation syndrome
- congenital central hypoventilation syndrome (odines curse)

respiratory muscle weakness
- motor neuron disease
- muscular dystrophy
- glycogen storage disease (pompe)

Question 4

What are the symptoms of chronic ventilatory failure?

Answer 4

ankle swelling (oedema)
- due to hypoxic cor pulmonale

breathlessness

disturbed sleep

morning headache

orthopnoea( breathless lying down)

paradoxical abdominal wall motion
- neuromuscular disease
- weak diaphragm sucked into chest during inspiration

recurrent chest infections

Question 5

What investigations is used for neuromuscular disease?

Answer 5

lung function
- mouth pressure/ SNP (sniff nasal pressure)

hypoventilation assessment
- early morning ABG (arterial blood gas)
- overnight oximetry
- transcutaneous CO2 monitoring

fluoroscopic diaphragm screening

Question 6

What treatment is used for chronic ventilatory failure ?

Answer 6

• non invasive ventilation
• oxygen therapy
• tracheostomy ventilation