RESPIRATORY FAILURE / HYPOXAEMIA

type 1 respiratory failure (low or normal pCO2):

(impaired gaseous exchange across alveolar membrane)

acute:

pulmonary oedema

pneumonia

bronchial asthma

pulmonary embolism

ARDS

chronic:

lung fibrosis (any cause; becomes type II later)

type 2 respiratory failure (high pCO2):

(alveolar hypoventilation)

acute (causing asphyxia):

severe acute asthma

upper airways obstruction:

foreign body

laryngeal oedema

obstructive sleep apnoea

major chest injury:

flail chest

tension pneumothorax

massive haemothorax

neurological lesions:

brainstem ischaemia

spinal cord trauma

transverse myelitis

central sleep apnoea

respiratory centre depression (opiates)

Guillain-Barre syndrome

muscle/neuromuscular junction problems:

myasthenia gravis

muscular dystrophy

chronic:

COPD

terminally in any progressive respiratory disease

severe chest deformity (kyphoscoliosis)

gross obesity

sleep apnoea syndromes

NB: if severe, causes of acute type 1 respiratory failure can also cause type 2 failure

non-respiratory causes of hypoxaemia:

decreased oxygen-carrying capacity of blood [normal pO2]:

anaemia

methaemoglobinaemia

CO poisoning

R to L shunting of blood

Eisenmenger's syndrome

low inhaled pO2

living at high altitudes

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