Respiratory failure
Framing
- Respiratory failure is classified as Type 1 (hypoxaemic, normal/low CO2 - a ventilation-perfusion mismatch or diffusion problem) or Type 2 (hypercapnic - a ventilatory pump failure problem, ± hypoxaemia) - this distinction directly determines management, since Type 2 failure raises the risk of worsening hypercapnia with uncontrolled high-flow oxygen and often requires non-invasive ventilation rather than oxygen alone
- Acute vs chronic tempo further refines management - chronic Type 2 failure (e.g. compensated COPD) tolerates a higher baseline CO2 with renal bicarbonate compensation, meaning blood gas interpretation must account for the patient's likely chronic baseline rather than treating every hypercapnic result as an acute crisis
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