Respiratory Failure Management
Respiratory failure means the lungs can no longer do their job unaided. Support ranges from oxygen and a tight mask through to full ventilation, and the level is chosen for what the patient needs now, then reduced as soon as they can manage more themselves.
- Non-invasive ventilation tried first where suitable
- Blood gases guide every change
- Ventilator settings matched to the lung problem
- Weaning begins as early as it is safe
Stay
Days to weeks
Duration
Until the lungs recover
Anaesthesia
Sedation while ventilated
About Respiratory Failure Management
The cause matters, because pneumonia, COPD, fluid on the lungs and ARDS each need different ventilator strategies. Non-invasive ventilation with a tight mask avoids intubation for many patients, particularly in COPD. Where a tube is needed, settings are matched to the underlying problem, and weaning is assessed daily rather than left to run.
- Non-invasive ventilation avoids a tube for many patients
- The ventilator strategy depends on the cause
- Blood gases guide adjustments rather than appearance
- Weaning is assessed every day
Before you read on
Everything here is general information about respiratory failure management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest respiratory failure management.
- Severe pneumonia not responding to oxygen
- Acute exacerbation of COPD with rising carbon dioxide
- Acute respiratory distress syndrome
- Fluid on the lungs from heart failure
- Respiratory failure after surgery
- Neuromuscular weakness affecting breathing
Procedure details
The usual sequence, from first consultation through to follow-up.
Assessment
Blood gases, chest imaging and examination establish the type and severity of respiratory failure and the likely cause.
Non-invasive support
A tight-fitting mask delivering pressurised air is tried first where suitable, and avoids intubation in many patients.
Invasive ventilation
Where a mask is not enough, a breathing tube is placed under sedation and the ventilator set for the specific lung problem.
Weaning
Sedation is lightened and breathing tested daily. The tube is removed once the patient can sustain their own breathing.
How to prepare
What to sort out before you come in.
- This is an emergency, so there is nothing to prepare
- Bring inhalers, home oxygen details and a medication list
- Mention previous intensive care admissions or ventilation
- Tell staff about sleep apnoea and any home CPAP machine
- Family should expect the patient to be sedated if ventilated
Recovery
What to expect afterwards, and roughly when.
- Coming off the ventilator is done gradually, often over several days
- A sore throat and a weak voice after the tube is removed are normal
- Breathing muscles are weak after prolonged ventilation and take time to recover
- Chest physiotherapy continues on the ward after intensive care
- Respiratory follow-up is arranged, particularly after prolonged ventilation
Why choose Humayun for respiratory failure
The goal in respiratory failure is the least support that works, for the shortest time it is needed.
- Non-invasive ventilation used in preference to a tube wherever the patient can manage it
- Blood gases tested at the bedside, so settings are changed on current information
- Ventilator strategies matched to the cause rather than one protocol for everyone
- Weaning assessed daily rather than support left running longer than needed
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