Chronic Respiratory Failure: First-Line Treatment and Oxygenation Targets

Clinical Scenario

Chronic respiratory failure requires careful oxygen management to correct impaired gas exchange while staying within a safe physiological window — avoiding both insufficient oxygenation (hypoxemia) and excess oxygen delivery (hyperoxemia).

Treatment Approach

First-line management centres on a specific form of high-flow nasal oxygen therapy. The full protocol details the clinical criteria, comparative guidance, and the rationale for choosing this modality — the complete algorithm and parameters remain in the structured protocol.

Target: PaO2 70–110 mmHg

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1186/s40560-023-00658-3

In the HFNC guidelines by the American College of Physicians, HFNC was weakly recommended for ARF over NPPV due to a systematic review reporting that HFNC for ARF is associated with lower mortality and a lower intubation rate compared to NPPV.
In these studies, the actual difference between study groups was 15–28 mmHg in PaO2 or 1–4% in SaO2, and PaO2 was maintained between 70 and 110 mmHg in both groups in all studies.

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