Respiratory failure

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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

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
 * Codeine,
 * Clozapine,
 * Fentanyl,
 * Gamma-Hydroxybutyric acid,
 * Heroin,
 * Ketamine,
 * Lidocaine,
 * Labetalol,
 * Lorazepam,
 * Morphine,
 * Nitrazepam,
 * Opiate,
 * Oxymorphone,
 * Procainamide (patient information),
 * Sodium thiopental,
 * Triazolam,
 * Zopiclone,

Complete Differential Diagnosis of Causes of Respiratory Failure
(In alphabetical order)


 * 3-Quinuclidinyl benzilate
 * Abrin
 * Acetylsalicylic acid
 * Achondrogenesis
 * Acute lung syndrome
 * Acute motor axonal neuropathy
 * Acute Porphyria
 * Acute Respiratory Distress Syndrome
 * Alcohol
 * Aldicarb
 * Alpha 1-antitrypsin deficiency
 * Alpha-amanitin
 * Amyotrophic Lateral Sclerosis
 * Anaphylaxis
 * Angioedema
 * Antiphospholipid Antibody Syndrome
 * Asbestosis
 * Aspiration
 * Atelectasis
 * Atelosteogenesis, type II
 * Atrial septal defect (ostium primum)
 * Babesiosis
 * Barium nitrate
 * Becker's muscular dystrophy
 * Bland-White-Garland Syndrome
 * Blood transfusion
 * Botulism
 * Bronchial asthma
 * Bronchiectasis
 * Bronchiolitis
 * Bronchiolitis obliterans
 * Bronchogenic carcinoma
 * Bronchopulmonary dysplasia
 * Bufotenin
 * Bungarotoxin
 * Carbon monoxide poisoning
 * Carnitine palmitoyltransferase II deficiency
 * Cholesterol Emboli Syndrome
 * Chronic Obstructive Pulmonary Disease
 * Clitocybe dealbata
 * Coal worker pneumoconiosis
 * Cocaine
 * Colchicine
 * Cone snail
 * Congenital Central Hypoventilation Syndrome
 * Congenital diaphragmatic hernia
 * Crimean-Congo hemorrhagic fever
 * Cystic adenomatoid malformation of lung
 * Cystic fibrosis
 * Cytisine
 * Devic's disease
 * Dicofol
 * Duchenne's Muscular Dystrophy
 * Ebstein anomaly
 * Eisenmenger syndrome
 * Elecrolyte abnormalities
 * Emphysema
 * Eosinophilic pneumonia
 * EVAR
 * Fallot tetralogy
 * Familial dysautonomia
 * Fat embolism
 * Fetal circulation, persistent
 * Fibrosing alveolitis
 * Flail chest
 * Foreign body
 * Furfural
 * Glotto Emphysema
 * Glycogen storage disease type I
 * Guillain-Barre syndrome


 * Hamman-Rich Syndrome
 * Hantavirus Pulmonary Syndrome
 * Heartworm
 * Hemosiderosis
 * Hepatic failure
 * Hepatopulmonary syndrome
 * Hereditary haemorrhagic telangiectasia
 * Human ehrlichiosis
 * Infant respiratory distress syndrome
 * Interstitial fibrosis
 * Kyphoscoliosis
 * Laryngo-/Bronchospasm
 * Legionella pneumophila
 * Malignant hyperpyrexia
 * Malignant Mesothelioma
 * Marine toxins
 * Meningitis
 * Metabolic Acidosis
 * Multiple chemical sensitivity
 * Multiple organ dysfunction syndrome
 * Muscarine
 * Myasthenia Gravis
 * Near-drowning
 * Omphalitis
 * Osteogenesis imperfecta
 * Pleural effusion
 * Pneumonia
 * Pneumothorax
 * Polio
 * Polyrediculitis
 * Post-polio syndrome
 * Potter syndrome
 * Pre-eclampsia
 * Pulmonary alveolar proteinosis
 * Pulmonary arterio-venous malformation
 * Pulmonary edema
 * Pulmonary embolism
 * Pulmonary hypertension
 * Pulmonary oedema
 * Pulmonary valve stenosis
 * Rabies
 * Respiratory distress syndrome (neonatal)
 * Restrictive Lung Disease
 * Reye's syndrome
 * Satoyoshi syndrome
 * Saxitoxin
 * Sepsis
 * Smoke inhalation
 * Snakebites (Patient information)
 * Status asthmaticus
 * Sulphur dioxide
 * Tetanus
 * Tetracycline antibiotics
 * Tetrodotoxin
 * Thanatophoric dysplasia
 * Tick paralysis
 * Transposition of great arteries
 * Tricuspid valve stenosis
 * Ventricular septal defect
 * Vinyl chloride
 * Zellweger syndrome

Complete Differential Diagnosis of the Causes of Respiratory failure
(By organ system)

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