Management of COVID-19 patients in Ventilatory failure

Most patients with COVID-19 who present to hospital will develop oxygenation failure, but for some patients who have certain underlying health conditions, they may be more at risk of developing ventilatory failure (i.e. pH < 7.35 and pCO2 >6.5kPa). Management of ventilatory failure is quite different to management of oxygenation failure, so it’s important that these patients are correctly identified.

Conditions that predispose a patient to ventilatory failure include:

  • COPD
  • Chest wall disease
  • Bronchiectasis
  • Neuromuscular disease
  • Obesity and obesity overlap

The All-Wales guidance for managing ventilatory failure should be applied to patients with COVID-19 who are in ventilatory failure, and this guideline (found below) will support teams to optimise non-invasive ventilation and correct the ventilatory failure.

The target oxygen saturations range for patients in ventilatory failure is 88-92%.

Mark as Understood


All-Wales Acute NIV Pathway

© Institute of Clinical Science and Technology (ICST) 2020