Lightning Learning: Respiratory Failure

Lightning Learning: Respiratory Failure

“Exacerbations of COPD can lead to retention of CO2, and 1-in-5 results in acute hypercapnic respiratory failure. This can be life-threatening.”
— advice is based on local guidelines & procedures


Acute hypercapnic respiratory failure is seen on an ABG and is defined as:

  • PaCO2 > 6kPa

  • pH < 7.35

There is often an element of hypoxia, which can be corrected with supplemental oxygen to a target SaO2 of 88-92%.

Hypercapnia can result in:

  • Cardiac arrest

  • Respiratory arrest

  • Coma

  • Seizures

  • Arrhythmia


Exacerbations of COPD can lead to retention of CO2 and 1-in-5 results in AHRF. This can be life-threatening. Following maximal medical management, non-invasive ventilation can be used to improve patient's own respiratory effort. Contraindications to NIV.

Absolute: Severe facial deformity, Facial burns, Fixed upper airway obstruction

Relative: pH <7.15, pH <7.25 and additional, adverse features, GCS <8,Agitation/confusion, Cognitive impairment

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Lightning Learning: Croup

Lightning Learning: Croup