Oxygenation Failure Patterns

Oxygenation failure means that oxygen is not moving adequately from the alveoli into arterial blood. A low pulse-ox reading is one clue, not the whole diagnosis. The nurse or NP must decide whether the patient has hypoxemic failure, ventilatory failure, or both; support breathing immediately; identify the cause; and judge the response after each intervention. The safe goal is adequate, controlled oxygenation rather than a saturation of 100% for every patient. Device choice, target SpO2, arterial blood-gas results, work of breathing, mental status, and the direction of change determine whether support can remain at the current level or must escalate.