RT Book, Section
A1 Naureckas, Edward T.
A1 Wood, Lawrence D. H.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Kress, John P.
SR Print(0)
ID 1107717933
T1 The Pathophysiology and Differential Diagnosis of Acute Respiratory Failure
T2 Principles of Critical Care, 4e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071738811
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107717933
RD 2024/04/19
AB Type  I  respiratory  failure,  characterized  by  severe,  oxygen-refractory  hypoxemia,  is  caused  by  a  portion  of  the  total  pulmonary  blood  flow  (Q˙ѕ/Q˙т)  traversing  the  lung  without  picking  up  oxygen  due  to  airspace  filling.When  blood  transport  of  oxygen  is  inadequate,  treatment  includes  optimizing  cardiac  output,  hemoglobin  concentration,  and  arterial  saturation,  and  lowering  oxygen  consumption.Optimizing  does  not  mean  maximizing,  and  the  end  point  of  each  therapeutic  approach  is  the  least  intervention  achieving  the  goal  of  that  treatment  and  needs  to  be  selected  for  the  individual  patient.Type  II  respiratory  failure  is  characterized  by  alveolar  hypoventilation  and  increased  PCO2,  caused  by  loss  of  CNS  drive,  impaired  neuromuscular  competence,  excessive  dead  space,  or  increased  mechanical  load.Type  III  respiratory  failure  typically  occurs  in  the  perioperative  period  when  factors  that  reduce  functional  residual  capacity  combine  with  causes  of  increased  closing  volume  to  produce  progressive  atelectasis.Type  IV  respiratory  failure  ensues  when  the  circulation  fails  and  resolves  when  shock  is  corrected,  as  long  as  one  of  the  other  types  of  respiratory  failure  has  not  supervened.Liberation  from  mechanical  ventilation  is  enhanced  by  identifying  and  correcting  the  many  factors  contributing  to  increased  respiratory  load  and  decreased  neuromuscular  competence.