Respiratory Failure: Types, Pathophysiology, Diagnosis and Treatment

Here we will discuss #respiratory failure , its etiology, #types #pathophysiology, classification, diagnostic approach, prognosis and treatment option, overall everything.
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Topics:
0:00 | what is respiratory failure?
0:49 | Etiology or causes
1:41 | Etiology or causes of ARF
2:38 | Pathophysiology
4:00 | Diagnosis of ARF
4:40 | Treatment of respiratory failure
7:30 | ventilator support in ARF
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Respiratory failure is classified according to blood gasses abnormalities into type 1 and type 2.
Type 1 is hypoxemic and type 2 is hypercapnic. Hypoxemic means the PaO2 in arterial blood is less than 60 mmHg and Hypercapnic refers to PaCO2 of more than 50 mmHg.
There are also two more types,
Type 3 (Perioperative). This is generally a subset of type 1 failure but is sometimes considered separately because it is so common.
Type 4 (Shock) - secondary to cardiovascular instability.
Pathophysiology of Respiratory Failure:
There are 3 main mechanisms of respiratory failure we need to look for.
Hypoventilation: Which is caused by drug-induced CNS depression. Hyperventilation means breathing too slowly, which results in inadequate oxygen supply to the demands of the body. This commonly happens due to reduced respiratory drive.

V/P mismatch: The most common cause of hypoxemia is a V/P mismatch. Hypoxemia is eliminated when 100 percent oxygen is administered.
ventilation perfusion mismatch is a condition in which one or more areas of the lung receive oxygen but no blood flow, or they receive blood flow but no oxygen.
Shunt: a condition in which despite 100% O2 inhalation, there is prolonged hypoxemia. When a shunt is present, deoxygenated blood (mixed venous blood) traverses the alveoli without being oxygenated, mixing with oxygenated blood that has passed through the vented alveoli, resulting in hypoxemia, as seen in pulmonary edema (cardiogenic or noncardiogenic), pneumonia, and atelectasis.

To confirm the diagnosis of respiratory failure,
arterial blood gasses (ABG) are required.
Chest radiography is required because it can detect lesions in the chest wall, pleura, and lung parenchyma.
The treatment goals of Acute respiratory failure
Correction of underlying gas abnormalities
Treating Infection and secondary cause of infection
Improving extra-pulmonary functions to improve respiration
Management of Long term complications of disease