Hi, welcome to our respiratory video series.
In this video, we're gonna take a look at respiratory failure,
acute and chronic and the differences in between that.
So we're gonna start off the
pretty simple straightforward definition.
What is respiratory failure?
Respiratory failure is a syndrome,
so that's when the respiratory system
isn't able to function adequately
for what the body needs.
Now it can be hypoxemic or hypercapnic.
Let's look at that first
one, hypo-, -oxemic, right?
I broke those two down because hypo- means
"low", -ox- is talking about oxygen in the blood
so when the respiratory system is in failure,
it causes a low level of oxygen in the blood
that's why we call it,
hypoxemic respiratory failure.
Now at the other end
hypercapnic, hyper- means "high",
If we're talking about -capnia, we're talking about
the CO2 level in the blood, the carbon dioxide.
So in respiratory failure causes a high level of carbon dioxide
in the blood, it's called hypercapnic respiratory failure.
Yeah trust me, you don't
want either one of these.
You want enough oxygen and not too much carbon dioxide
in the blood in order to be breathing adequately.
So respiratory failure is a syndrome.
Now it might be low oxygen or extra high carbon
dioxide, but either way it's respiratory failure.
So do you have respiratory
failure that's one or both?
Well respiratory failure is failing in one or
the other, so it's not just both have to be present
but in respiratory failure, the respiratory system is failing
either in one or both of the gas exchanges that it controls.
Now the respiratory system's job is to
bring oxygen in, take carbon dioxide out.
So the patient may have one or
both of these values way out of wack
So this is the way we talk about respiratory
failure, it's either type I or type II.
type I is low oxygen,
hypoxemic respiratory failure.
Type II is hypercapnic - that's high
CO2, high carbon dioxide respiratory failure.
Now how do we determine which
one it really is or what the problem is?
We are gonna need to
have arterial blood gases.
We're gonna start off with
type I - so this is low oxygen.
Now how we technically define it is a PaO2, which I would
find in an arterial blood gas, that's lower than 60 (mmHg)
So I look at the ABG so I draw an arterial blood
gas sample, the O2 would be lower than 60 (mmHg)
but the CO2, the carbon
dioxide is normal or a little bit low,
that would make hypoxemic
or type I respiratory failure.
Now type I is the most common
form of respiratory failure.
It's usually caused by acute diseases of the lungs that
cause the alveoli to fill with fluid or to collapse
so you'll see a lot of
type I respiratory failure.
Now let's talk a little bit more of some of the diseases of
the lungs that cause the alveoli to fill with fluid or collapse.
Really feel like it today, pause the video
and see if you can list out 3 to 4 diagnoses.
Okay, let's see which of these you came up with.
Some examples of type I respiratory failure are
cardiogenic or noncardiogenic pulmonary edema.
Now, -gen you think of producing something like 'genesis',
cardiogenic means the heart caused the pulmonary edema.
that means the heart couldn't pump efficiently
and fluid start backing up into the lungs.
Noncardiogenic pulmonary edema is still
pulmonary edema but it's not the heart's fault.
Pneumonia and pulmonary hemorrhage are
other examples of what disease of the lungs
that cause the alveoli to
fill with fluid or collapse.
So when you think of those two things we're
going to end up in type I respiratory failure,
pulmonary edema pneumonia
or pulmonary hemorrhage
Let's talk about type II, this is
hypercapnic respiratory failure.
Now this is when the carbon dioxide or the PaCO2 is
higher than 50 (mmHg) on the arterial blood gases.
Okay, now patient can also
commonly have hypoxemia -low oxygen
when they have hypercapnic respiratory
failure if they're breathing room air.
So we're looking at the marker, the definition of a
CO2, a carbon dioxide that's higher than 50 (mmHg)
on arterial blood gases, and also keeping in mind if
they're breathing room air or probably also hypoxemic.
So what can cause this, well
these are some really sad stories.
This could be a drug overdose, neuromuscular
disease, something wrong with the chest wall,
he might have a severe airway disorder like
asthma, COPD, those chronic type diseases
so you can also see hypercapnic
respiratory failure which is type II.
So pause for just a minute and make sure you're
very clear on the differences of type I and type II,
it's all about the O2 levels and the
CO2 levels on arterial blood gases.