Respiratory failure classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]

Overview

Respiratory failure may be classified into several subtypes as follows; Type I, Type II, Type III, Type IV.

Classification

The classification of respiratory failure is as follows:^[1]

Respiratory Failure

Type I

Type II

Type III

Type IV

Hypoxemic

Hypercapnic

Peri-operative

Shock

Classification based on A-a gradient

Respiratory failure patients may have a normal or increased A-a gradient depending upon the etiology of the respiratory failure. The following table outlines the major characteristics:

Respiratory Failure-decreased SaO2

Normal A-a gradient

Increased A-a gradient

Normal PaCO2

Increased PaCO2

Hypoxemia does not correct with 100% O2

Hypoxemia corrects with 100% O2

Decreased FiO2 or decreased PiO2

Hypoventilation (sedation, COPD, asthma, diaphragmatic paralysis or Neuromuscular disease)

True shunt (Left to right shunts, CHF, pneumonia, atelectasis)

Vascular disease (pulmonary embolism), airway disease (COPD, asthma), alveolar filling (CHF, pneumonia)

References

↑ Hall, Jesse (2015). “CHAPTER 43: The Pathophysiology and Differential Diagnosis of Acute Respiratory Failure”. Principles of critical care. New York: McGraw-Hill Education. ISBN 0071738819.

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[1] Hall, Jesse (2015). “CHAPTER 43: The Pathophysiology and Differential Diagnosis of Acute Respiratory Failure”. Principles of critical care. New York: McGraw-Hill Education. ISBN 0071738819.

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