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Respiratory Failure

Respiratory Failure

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Published by: api-19826220 on Nov 30, 2009
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03/18/2014

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Respiratory Failure
Barry Wardle
Introduction

\u2022Respiratory failure is a syndrome in which the respiratory system fails in one or both of its gas exchange functions: oxygenation and carbon dioxide elimination.

\u2022In practice, respiratory failure is defined as a PaO2 value of less than 60 mm Hg while breathing air or a PaCO2 of more than 50 mm Hg.

\u2022Furthermore, respiratory failure may be acute or chronic.
While acute respiratory failure is characterized by life-
threatening derangements in arterial blood gases and
acid-base status, the manifestations of chronic
respiratory failure are less dramatic and may not be as
readily apparent.

Classification of respiratory
failure
\u2022Respiratory failure may be classified as hypoxemic or hypercapnic
and may be either acute or chronic.
\u2022Hypoxemic respiratory failure (type I) is characterized by a PaO2 of
less than 60 mm Hg with a normal or low PaCO2.

\u2022This is the most common form of respiratory failure, and it can be
associated with virtually all acute diseases of the lung, which
generally involve fluid filling or collapse of alveolar units.

\u2022Some examples of type I respiratory failure are cardiogenic or noncardiogenic pulmonary edema, pneumonia, and pulmonary hemorrhage.

\u2022Hypercapnic respiratory failure (type II) is characterized by a PaCO2
of more than 50 mm Hg. Hypoxemia is common in patients with
hypercapnic respiratory failure who are breathing room air.

\u2022The pH depends on the level of bicarbonate, which, in turn, is
dependent on the duration of hypercapnia.

\u2022Common etiologies include drug overdose, neuromuscular disease, chest wall abnormalities, and severe airway disorders (eg, asthma, chronic obstructive pulmonary disease [COPD]).

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