Type II Respiratory Failure

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 21 March 2016

⏱️ 20 minutes

🔗️ Recording | iTunes | RSS

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Summary

So in this short podcast we're going to run over the summary of recommendations just published by the British Thoracic Society and the Intensive Care society on the Ventilatory Management of Acute Hypercapnia Respiratory Failure in Adults. This isn't in anyway intended as a replacement for reading the document itself so please make sure you take the time to do that.

Transcript

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0:00.0	Hello and welcome back to the management of type 2 respiratory failure.
0:35.8	The document itself is definitely worth a full read but I think in
0:39.5	total there are about 82 recommendations that they actually make. So there is no way
0:45.7	that we're going to run through all of those in this podcast. You'll definitely be
0:48.9	drifting off to sleep by the end of it if I also do that. So what I'm going to do
0:53.4	is just highlight the
0:54.6	things that you need to know will make the difference in your decision-making in
0:58.8	the recess room. A lot of these aren't going to be groundbreaking, there'll be things
1:03.4	that you already know, but it's just useful to have a bit of a recap of them and there
1:07.3	will be some things in here hopefully that will be a bit of news for you.
1:12.1	If you haven't got the time for whatever reason to listen to the full podcast which is probably
1:16.2	going to be 10 or 15 minutes long then have a look at my Twitter handle at Lang underscore Simon
1:22.7	and there you'll find a 30 second video of the key points of the guideline.
1:28.3	But as I mentioned, it'd be much, much better if you could actually have a look through the whole guideline itself and the document is hyperlinked on the website for you.
1:37.3	So, without further ado, let's crack on with it.
1:41.3	As we run through the guideline, rather than the tongue twister of acute hypercatinic
1:48.0	respiratory failure, will be referring it to AHRF. An interesting point before we start the actual
1:54.6	guideline as well is that they do mention in the paper that AHRF complicates around 20% of acute exacerbations of COPD. So this is something
2:04.5	that you're going to see day in, day out in your standard ED and recess care. So it's something
2:10.1	that we do all really need to know about. So let's start off with the definition from the paper.
2:16.4	So what is AHRF? Well it is respiratory failure with a pH of less than 7.35 and a PCO2 of greater than 6.5 kilopascals.
2:31.3	We're going to run through it in the sort of order that you're going to think about things in the recess room. So first of all, what is the initial treatment when you find
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