![]() ![]() Exacerbations of both conditions are largely caused by infection, resulting in heightened airway inflammation in association with a deterioration in symptoms and lung function.Īlthough the nature of the inflammation in the two conditions is dissimilar, the principles of treatment and many of the agents used are the same. Exacerbation of chronic obstructive pulmonary disease is the most important cause of hypercapnic respiratory failure the increased load of the respiratory system and reduced muscular force induce the patient to adopt a rapid shallow breathing pattern in order to preserve the ventilatory pump from fatigue and exhaustion.Įxacerbations of the major obstructive lung diseases, asthma and chronic obstructive pulmonary disease (COPD), cause considerable morbidity, mortality, hospital admission and healthcare cost. Causes of pump failure can be grouped into three major categories: central depression, mechanical defect of the ventilatory pump, and muscle fatigue. Normally, the ventilatory drive adjusts the output of the muscular pump in proportion to metabolic activity, in order to maintain arterial blood pH within narrow limits (7.38–7.42). Most hypercapnic states result from inadequate clearance due to alveolar hypoventilation and increased dead space (dead space/tidal volume) this may happen in parenchymal diseases such as emphysema and in circulatory problems such as pulmonary embolism. The prevalence of hydrostatic (ACPO) or inflammatory (ALI, ARDS) mechanisms in pulmonary oedema deeply impacts upon clinical course and outcome. Alveolar flooding is generally the most important mechanism underlying severe hypoxaemic states such as acute cardiogenic pulmonary oedema (ACPO), acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). ![]() The most important causes of hypoxaemia are impaired diffusion, ventilation/perfusion mismatch and shunt, whereas alveolar collapse, alveolar flooding and impaired hypoxic pulmonary vasoconstriction are the main pathological mechanisms. Any condition in which the arterial oxygen tension is 6.5–6.6 kPa, with or without acidosis (arterial blood pH <7.36). oxygenation and clearance of carbon dioxide. Respiratory failure is a condition in which the respiratory system fails in one or both of its gas exchange functions, i.e.
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