Respiratory failure classification

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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

  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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