Hypercapnic respiratory failure in adult patients

​​​Emergency

If any of the following are suspected, please seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary):

  • Acute respiratory acidosis
  • Altered level of consciousness
  • Respiratory distress secondary to hypercapnic respiratory failure

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Associated congestive cardiac failure or severe pulmonary arterial hypertension due to untreated hypercapnic respiratory failure
  • Confirmed hypercapnic respiratory failure on arterial blood gas (ABG) with > 1 hospital admissions due to any of the following underlying conditions:
    • Bronchiectasis
    • Chest wall deformity
    • Chronic obstructive pulmonary disease
    • Neuromuscular disease,
    • Obesity hypoventilation syndrome
    • Severe obstructive sleep apnoea
  • Recent discharge from hospital and recently initiated non-invasive ventilation for hypercapnic respiratory failure
  • Symptomatic motor neurone disease or rapidly progressive neuromuscular disease with daytime hypercapnia

Category 2
Recommended to be seen within 90 calendar days.

  • Compensated hypercapnic respiratory failure on ABG
  • Overnight hypoventilation diagnostic sleep study or overnight oximetry


 

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration, and impact on activities of daily living
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically body mass index

If available

 

  • Echocardiogram test
  • Lung function test
  • Previous arterial blood gas report
  • Scores of symptomatic sleepiness (e.g. ESS, STOP-BANG, OSA-50, Berlin questionnaire)
  • (if obstructive sleep apnoea is suspected in addition to hypercapnic respiratory failure)
  • Sleep studies

 

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.


 

Current as at: Thursday 10 September 2026
Contact page owner: System Purchasing