TY - CHAP M1 - Book, Section TI - The Pathophysiology and Differential Diagnosis of Acute Respiratory Failure A1 - Naureckas, Edward T. A1 - Wood, Lawrence D. H. A2 - Hall, Jesse B. A2 - Schmidt, Gregory A. A2 - Kress, John P. PY - 2015 T2 - Principles of Critical Care, 4e AB - Type I respiratory failure, characterized by severe, oxygen-refractory hypoxemia, is caused by a portion of the total pulmonary blood flow (Q˙ѕ/Q˙т) traversing the lung without picking up oxygen due to airspace filling.When blood transport of oxygen is inadequate, treatment includes optimizing cardiac output, hemoglobin concentration, and arterial saturation, and lowering oxygen consumption.Optimizing does not mean maximizing, and the end point of each therapeutic approach is the least intervention achieving the goal of that treatment and needs to be selected for the individual patient.Type II respiratory failure is characterized by alveolar hypoventilation and increased PCO2, caused by loss of CNS drive, impaired neuromuscular competence, excessive dead space, or increased mechanical load.Type III respiratory failure typically occurs in the perioperative period when factors that reduce functional residual capacity combine with causes of increased closing volume to produce progressive atelectasis.Type IV respiratory failure ensues when the circulation fails and resolves when shock is corrected, as long as one of the other types of respiratory failure has not supervened.Liberation from mechanical ventilation is enhanced by identifying and correcting the many factors contributing to increased respiratory load and decreased neuromuscular competence. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1107717933 ER -