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The primary goal during the second phase of managing acute respiratory failure is to support ventilation and oxygenation. This phase typically follows initial stabilization and assessment, where immediate airway concerns are addressed. During this phase, the focus shifts to the maintenance of adequate gas exchange and ensuring that oxygen delivery meets the metabolic needs of the body.

Ventilatory support might involve adjusting the settings of mechanical ventilation, employing non-invasive ventilation techniques, or providing supplemental oxygen. The underlying cause of respiratory failure should also be addressed, which includes treating conditions like pneumonia, COPD exacerbations, or pulmonary edema. The aim is to ensure that the patient's pH and blood gases are stabilized while avoiding the complications associated with inadequate ventilation or oxygenation, such as respiratory acidosis or hypoxemia.

Supporting ventilation and oxygenation optimally sets the tone for further interventions, including rehabilitation strategies or nutritional support, which may come into play later in the patient's recovery process. Proper management during this critical phase can significantly influence morbidity and mortality outcomes in patients suffering from acute respiratory failure.