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Respiratory failure is a medical term for inadequate gas exchange by the respiratory system. Respiratory failure can be indicated by observing a drop in blood oxygen level (hypoxemia) and/or a rise in arterial carbon dioxide (hypercapnia). Classification into type I or type II relates to the absence or presence of hypercapnia respectively.
Types
Type 1
- Type 1 respiratory failure is defined as hypoxia without hypercapnia, indeed the CO2 level may be normal or low. It is typically caused by a ventilation/perfusion mismatch; the air flowing in and out of the lungs is not matched with the flow of blood to the lungs.
- Causes:
Type 2
- Type 2 respiratory failure is defined as hypoxia with hypercapnia. It is due to inadequate air flow in the alveoli of the lungs that causes a build up of carbon dioxide that has been generated by the body. The underlying causes are reduced breathing effort (in the fatigued patient), increased resistance to breathing (such as in asthma) or an increase in the area of the lung that is not available for gas exchange (such as in emphysema).
- Causes:
- Asthma
- Emphysema
- Chronic obstructive airway disease
- Pneumonia
- Respiratory sedation
- Flail chest
Causes
- Pulmonary dysfunction
- Asthma
- Emphysema
- Chronic obstructive airway disease
- Pneumonia
- Pneumothorax
- Hemothorax
- Acute Respiratory Distress Syndrome (ARDS) is a specific and life-threatening type of respiratory failure.
- Cardiac dysfunction
- Pulmonary edema
- Arrhythmia
- Congestive heart failure
- Valve pathology
- Other
- Fatigue due to prolonged tachypnoe in metabolic acidosis
- Intoxication with drugs (i.e. morphine, benzodiazepines) suppresses respiration
Treatment
Emergency treatment follows the principles of cardiopulmonary resuscitation. Treatment of the underlying cause is required. Mechanical ventilation may be required.
Emergency medicine | Intensive care medicine | Medical emergencies | Organ failure | Pulmonology | Causes of death
"Respiratory failure"