Hypercapnoeia (Type II Respiratory Failure)

Suggested approach and Clinical Pearls

• Type 2 respiratory failure requires an acidosis associated with an abnormally high PaCO2
• Improving patient ventilation resolves Type 2 respiratory failure
  • Open and maintain the airway
    • Consider airway management – chin lift, jaw thrust, oropharyngeal/nasopharyngeal airways, LMA, ETT
  • Improve ventilation 
    • Patient characteristics
      • Sit up, reverse neuromuscular or respiratory depressant drug effects, decompress abdomen
    • Treatment options
      • Manual ventilation - BMV
      • mechanical ventilation – non-invasive or invasive (emergent full face non-invasive ventilation can be delivered in the inpatient setting while awaiting admission to ICU or determining whether aggressive therapy is indicated)
• Consider location of ongoing care that is appropriate for patient based on patient needs, behaviour and anticipated plan