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Anaesthesia · Critical care, resuscitation, and emergency principles: curriculum recognition
Sample itemA patient with pneumonia breathing room air has a PaO2 of 52 mmHg, a PaCO2 of 30 mmHg and a pH of 7.47. Which classification applies?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Hypoxaemic (type 1) respiratory failure
Type 1 failure is a PaO2 below 60 mmHg with a normal or low PaCO2, as in pneumonia, oedema and ARDS. Type 2 failure has a PaCO2 above 50 mmHg from inadequate ventilation. The low PaCO2 here reflects compensatory hyperventilation.
Option by option
A. Compensated chronic ventilatory failure
Chronic compensated failure would show a raised PaCO2 and bicarbonate.
B. Hypoxaemic (type 1) respiratory failure (correct)
Correct. Low PaO2 with low PaCO2 defines type 1 failure.
C. Hypercapnic (type 2) respiratory failure
Type 2 failure needs a raised PaCO2.
D. Normal gas exchange with hyperventilation
A PaO2 of 52 mmHg is abnormal, so gas exchange is not normal.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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