This document summarizes respiratory failure, including its types, causes, clinical manifestations, diagnosis, treatment, and considerations for older patients. Respiratory failure occurs when the lungs cannot effectively exchange oxygen and carbon dioxide and can be acute or chronic. The two main types are hypoxemic respiratory failure, characterized by low blood oxygen, and hypercapnic respiratory failure, characterized by high blood carbon dioxide. Causes range from lung diseases like COPD to neurological conditions. Treatment involves oxygen therapy, medications, and nutrition management.

2. Respiratory
Failure.
C r e a t e d B y :
S a a d i y a N a e e m i .
P r e s e n t e d b y : K a l p a n a
S u r e s h K u m a r

3. OUTLINE
1. Respiratory Failure.
2. Types Of Respiratory Failure.
3. Clinical Manifestations.
4. Diagnosis Importance.
5. Gerontologic Considerations.
6. Treatment.

4. Respiratory Failure:
The inability of the cardiac and pulmonary systems to
maintain an adequate exchange of oxygen and CO2 in the
Lungs.

5. •Types Of Respiratory
Failure:
Following are the two types of Respiratory Failure:
1 . A c u t e R e s p i r a t o r y F a i l u r e .
2 . C h r o n i c R e s p i r a t o r y F a i l u r e .

6. Acute Respiratory Failure:
Results from inadequate gas exchange for a short
period.
• Insufficient O2 transferred to the blood
Hypoxemia (type I)
• Inadequate CO2 removal
Hypercapnia (Type II)

7. Acute Respiratory Failure:
Classification
• Hypoxemic respiratory failure(Type I)
An arterial oxygen tension lower than 60 mm Hg with a normal or low
arterial carbon dioxide tension.
• Hypercapnic respiratory failure(Type II)
CO2 higher than 50 mm Hg.

8. • Hypoxemic Respiratory
Failure (Type I)
Causes
1. Ventilation-perfusion (V/Q) mismatch
2. Shunt
3. Diffusion Limitation
4. Alveolar hypoventilation

9. • Hypoxemic Respiratory
Failure(Type I)
1. Ventilation-perfusion (V/Q) mismatch:
"V" – ventilation – the air that reaches the alveoli
"Q" – perfusion – the blood that reaches the alveoli
o COPD
o Pneumonia
o Asthma
o Atelectasis
o Pulmonary embolus

10. o COPD:
COPD stands for Chronic Obstructive
Pulmonary Disease. It is a progressive
disease that makes it hard to breathe.
In COPD, less air flows in and out of the
airways because of one or more of the
following:
•The airways and air sacs lose their
elastic quality.
•The walls between many of the air sacs
are destroyed.
•The walls of the airways become thick
and inflamed.
•The airways make more mucus than
usual, which can clog them.

11. Partial collapse or incomplete inflation of the lung.
o Atelectasis:
o Pneumonia:
Pneumonia is an inflammatory condition of the lung. It is usually
caused by infection with viruses or bacteria.
o Asthma:
A respiratory condition marked by attacks of spasm in the bronchi
of the lungs, causing difficulty in breathing. It is usually connected
to allergic reaction or other forms of hypersensitivity.

12. Pulmonary embolism is the sudden blockage of a major blood
vessel (artery) in the lung, usually by a blood clot.
o Pulmonary embolus:

13. • Hypoxemic Respiratory
Failure (Type I)
2. Shunt
o Anatomic shunt
o Intrapulmonary shunt

14. o Anatomic shunt:
Passes through an anatomic channel of the heart and does not
pass through the lungs.
o Intrapulmonary shunt:
Blood flows through pulmonary capillaries without participating in
gas exchange.

15. • Hypoxemic Respiratory
Failure (Type I)
3. Diffusion Limitation:
o Severe emphysema
o Recurrent pulmonary emboli
o Pulmonary fibrosis
o Hypoxemia present during exercise

16. o Severe Emphysema:
Emphysema gradually damages the air sacs (alveoli) in your lungs,
making you progressively more short of breath. Smoking is the leading
cause of emphysema.
o Recurrent pulmonary emboli:
Pulmonary embolism (PE) occurs when a blood clot dislodges from a
vein, travels through the veins of the body, and lodges in the lung.
o Pulmonary fibrosis:
Pulmonary fibrosis occurs when lung tissue becomes damaged. This
thickened, stiff tissue makes it more difficult for your lungs to work
properly.
o Hypoxemia present during exercise:
An abnormally low concentration of oxygen in the blood.

17. • Hypoxemic Respiratory
Failure
4. Alveolar hypoventilation:
o Restrictive lung disease
o CNS disease
o Chest wall dysfunction
o Neuromuscular disease

18. • Hypercapniac Respiratory
Failure (Type II)
Causes:
1. Airways and alveoli.
2. Central Nervous System.
3. Chest Wall.
4. Neuromuscular Conditions.

19. • Hypercapniac Respiratory
Failure (Type II)
1. Airways and alveoli:
o Asthma.
o Emphysema.
o Bronchitis.
o Cystic fibrosis.

20. o Bronchitis:
Bronchitis is an inflammation of the bronchial tubes.
o Cystic fibrosis:
A heriditary disorder causes the production of abnormally thick
mucus, leading to the blockage of bronchi.

21. • Hypercapniac Respiratory
Failure (Type II)
2. Central Nervous System:
o Drug overdose.
o Brainstem infarction.
o Spinal cord injuries.

22. • Hypercapniac Respiratory
Failure(Type II)
3. Chest Wall:
o Flail chest.
o Fractures.
o Muscle spasm.

23. • Hypercapniac Respiratory
Failure (Type II)
3. Neuromuscular Conditions:
o Muscular Dystrophy.
o Multiple Sclerosis.

24. o Multiple Sclerosis:
Multiple sclerosis (MS) is a disease in which your immune system
attacks the protective sheath (myelin) that covers your nerves. Myelin
damage disrupts communication between your brain and the rest of your
body. Ultimately, leading to respiratory failure and other diseases.

25. • Chronic Respiratory Failure:
The respiratory failure which passes
the acute stage. All of the disorders are same,
just the duration is lengthened.

26. •Tissue Organ Needs:
Major threat is the inability of the lungs to meet the
oxygen demands of the tissues.
• Clinical Manifestations:
A sudden decrease in O2 or rapid increase in CO2 indicates a
serious condition

27. Diagnostic Studies:
o History.
o Physical assessment.
o Chest x-ray.
o ECG.

28. Gerontologic
Considerations:
o ↓ Ventilatory capacity.
o Alveolar dilation.
o Larger air spaces.
o Loss of surface area .
o Decreased respiratory muscle strength.

29. Treatment:
1. Oxygen Therapy.
2. Drug Therapy.
3. Nutritional Therapy.

30. 1. Oxygen Therapy:
Oxygen therapy is a treatment that provides you with extra oxygen,
a gas that your body needs to work well.
Nasal canula.Face mask.

31. 2. Drug Therapy:
Use of Bronchodilators, Anti-biotics etc
3. Nutritional Therapy:
•Maintain protein and energy stores.

32. Questions
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