Acute & emergency · UKMLA & AKT
Type 2 respiratory failure
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise type 2 respiratory failure — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Type 2 respiratory failure = hypoxia + hypercapnia (PaO2 <8 kPa, PaCO2 >6 kPa) due to alveolar hypoventilation
- In acute severe asthma, hyperventilation causes low PaCO2 and respiratory alkalosis - a normal or rising PaCO2 (>6.0 kPa) means the patient is tiring and hypoventilating; this is a near-fatal sign
- Chronic hypercapnia (e.g. COPD): kidneys compensate by retaining HCO3- → raised PaCO2, raised HCO3-, near-normal pH
A normal pCO2 in a tachypnoeic asthmatic is NOT reassuring - it signals exhaustion and impending respiratory arrest. Expect low pCO2 during active hyperventilation; normalisation = deterioration.
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