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Respiratory failure is classified as either Type 1 or Type 2, based on whether there is a high carbon dioxide level, and can be acute or chronic. In clinical trials, the definition of respiratory failure usually includes increased respiratory rate , abnormal blood gases (hypoxemia, hypercapnia, or both), and evidence of increased work of breathing.
High-flow therapy is useful in patients that are spontaneously breathing but are in some type of respiratory failure. These are hypoxemic and certain cases of hypercapnic respiratory failure stemming from exacerbations of asthma and chronic obstructive pulmonary disease, bronchiolitis, pneumonia, and congestive heart failure are all possible ...
Many people with chronic obstructive pulmonary disease have a low partial pressure of oxygen in the blood and high partial pressure of carbon dioxide.Treatment with supplemental oxygen may improve their well-being; alternatively, in some this can lead to the adverse effect of elevating the carbon dioxide content in the blood (hypercapnia) to levels that may become toxic.
In these instances, oxygen therapy may decrease respiratory drive, leading to accumulation of carbon dioxide (hypercapnia), acidemia, and increased mortality secondary to respiratory failure. [25] Improved outcomes have been observed with titrated oxygen treatment largely due to gradual improvement of the ventilation/perfusion ratio. [26]
Tissue hypoxia refers to low levels of oxygen in the tissues of the body and the term hypoxia is a general term for low levels of oxygen. [2] Hypoxemia is usually caused by pulmonary disease whereas tissue oxygenation requires additionally adequate circulation of blood and perfusion of tissue to meet metabolic demands.
Chronic alveolar hypoxia is the main factor leading to development of cor pulmonale — right ventricular hypertrophy with or without overt right ventricular failure — in patients with COPD. Pulmonary hypertension adversely affects survival in COPD, proportional to resting mean pulmonary artery pressure elevation.
Treatment is focused on three aspects: improving respiratory function, treating the underlying cause, and; preventing further damage and allow full recovery to the lung. Pulmonary edema can cause permanent organ damage, and when sudden (acute), can lead to respiratory failure or cardiac arrest due to hypoxia. [7]
The standard drug treatment of dexamethasone does not alter the hypoxia or the consequent vasoconstriction, but stimulates fluid reabsorption in the lungs to reverse the edema. Additionally, several studies on native populations remaining at high altitudes have demonstrated to varying degrees the blunting of the HPV response.
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