Respiratory failure

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Respiratory failure
ICD-10 J96
ICD-9 518.81
DiseasesDB 6623
eMedicine med/2011 
MeSH D012131

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] M.Umer Tariq [3]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [4] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

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) which can be written as (PaO2 < 60 mmHg, PaCO2 >45 mmHg).

Classification into type I or type II relates to the absence or presence of hypercapnia respectively. (Values in kPA being PO2 below 8kPA and PCO2 above 6.7kPa

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. This type is caused by conditions that affect oxygenation like:

1.parenchymal disease (v-q mismatch)

2.diseases of vasculature and shunts.

Type 2

  • Type 2 respiratory failure is defined 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 of Hypoventilation

Drugs

more on Dyspnea

Complete Differential Diagnosis of Causes of Respiratory Failure

(In alphabetical order)


Complete Differential Diagnosis of the Causes of Respiratory failure

(By organ system)

Cardiovascular

Atrial septal defect (ostium primum), Ebstein anomaly, Eisenmenger syndrome, Fallot tetralogy, Pulmonary valve stenosis, Transposition of great arteries, Tricuspid valve stenosis, Ventricular septal defect,

Chemical / poisoning 3-Quinuclidinyl benzilate,

Abrin, Aldicarb, Alpha-amanitin, Barium nitrate, Bungarotoxin, Carbon monoxide poisoning, Cocaine, Cone snail, Furfural, Snakebites (Patient information),

Congenital

Atrial septal defect (ostium primum), Bland-White-Garland Syndrome, Congenital Central Hypoventilation Syndrome, Congenital diaphragmatic hernia, Fallot tetralogy, Fetal circulation, persistent, Respiratory distress syndrome (neonatal),

Dermatologic No underlying causes
Drug Side Effect
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental

Asbestosis, Coal worker pneumoconiosis, Smoke inhalation, Sulphur dioxide,

Gastroenterologic

Hepatic failure, Hepatopulmonary syndrome,

Genetic

Achondrogenesis, Acute Porphyria, Alpha 1-antitrypsin deficiency, Atelosteogenesis, type II, Becker's muscular dystrophy, Carnitine palmitoyltransferase II deficiency, Cystic fibrosis, Duchenne's Muscular Dystrophy, Familial dysautonomia, Hereditary haemorrhagic telangiectasia, Osteogenesis imperfecta, Thanatophoric dysplasia,

Hematologic

Acute Porphyria, Cholesterol Emboli Syndrome, Fat embolism, Sepsis,

Iatrogenic

Blood transfusion, EVAR,

Infectious Disease

Babesiosis, Botulism, Crimean-Congo hemorrhagic fever, Hantavirus Pulmonary Syndrome, Heartworm, Post-polio syndrome, Rabies, Tetanus,


Musculoskeletal / Ortho

Kyphoscoliosis,

Neurologic

Amyotrophic Lateral Sclerosis, Meningitis, Polyrediculitis, Zellweger syndrome,

Nutritional / Metabolic

Metabolic Acidosis,

Obstetric/Gynecologic No underlying causes
Oncologic

Malignant Mesothelioma,

Opthalmologic No underlying causes
Overdose / Toxicity

Acetylsalicylic acid, Alcohol, Bufotenin, Clitocybe dealbata, Colchicine, Cytisine, Dicofol, Saxitoxin, Tetrodotoxin, Tick paralysis, Vinyl chloride,

Psychiatric No underlying causes
Pulmonary

Acute lung syndrome, Acute Respiratory Distress Syndrome, Alpha 1-antitrypsin deficiency, Atelectasis, Bronchial asthma, Bronchiectasis, Bronchiolitis, Bronchiolitis obliterans, Bronchogenic carcinoma, Bronchopulmonary dysplasia, Chronic Obstructive Pulmonary Disease, Cystic adenomatoid malformation of lung, Emphysema, Eosinophilic pneumonia, Fibrosing alveolitis, Flail chest, Interstitial fibrosis, Laryngo-/Bronchospasm, Legionella pneumophila, Pleural effusion, Pneumonia, Pneumothorax, Pulmonary alveolar proteinosis, Pulmonary arterio-venous malformation, Pulmonary edema, Pulmonary embolism, Pulmonary hypertension, Pulmonary oedema, Restrictive Lung Disease, Status asthmaticus,


Renal / Electrolyte

Elecrolyte abnormalities,

Rheum / Immune / Allergy

Acute motor axonal neuropathy, Anaphylaxis, Angioedema, Antiphospholipid Antibody Syndrome, Devic's disease, Guillain-Barre syndrome, Hamman-Rich Syndrome, Myasthenia Gravis, Satoyoshi syndrome,


Trauma

Ebstein anomaly, Flail chest,

Urologic No underlying causes
Miscellaneous

Aspiration, Foreign body, Malignant hyperpyrexia, Multiple organ dysfunction syndrome, Near-drowning, Reye's syndrome,


Treatment

Emergency treatment follows the principles of cardiopulmonary resuscitation. Treatment of the underlying cause is required. Mechanical ventilation may be required.

External Links

eMedicine Respiratory Failure [5]

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