Respiratory failure pathophysiology

Respiratory failure Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

• The respiratory system is formed by 2 parts:
  • The gas exchanging organ, the lung
  • The pump that ventilates the lungs, the pump consists of:
    • Chest wall, the respiratory muscles
    • The respiratory control system in the central nervous system (CNS)
    • The spinal and peripheral pathways that connect the CNS control system with the respiratory muscles
• The respiratory system has 2 main functions oxygenation of mixed venous blood and elimination of carbon dioxide.
• Respiratory failure is a condition where there is loss of one or both of the functions of the respiratory system.
• Respiratory failure is defined as:
  • Arterial oxygen tension (PaO2) < 60 mmHg
  • Arterial carbon dioxide (PaCO2) > 45 mmHg
• Respiratory failure can be caused by lung failure or pump failure.
• Lung failure, which is gas exchange failure resulting in hypoxemia (<PaO2).
• Pump failure, which is ventilatory failure resulting in alveolar hypoventilation which in turn results in hypercapnia (>PaCO2).
• Hypercapnic respiratory failure can be caused by:
  • Mechanical defects
  • Central nervous system depression
  • Imbalance of energy demands and supplies
  • Adaptation of central controllers
  • Neuromuscular transmission impairment
  • Mechanical defect of the rib cage
  • Fatigue of respiratory muscles
• Lung failure and pump failure can coexist in the same patient in cases of:
  • Chronic obstructive pulmonary disease (COPD) with carbon dioxide retention
  • Severe pulmonary edema
  • Asthmatic crisis

Genetics

• [Disease name] is transmitted in [mode of genetic transmission] pattern.
• Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
• The development of [disease name] is the result of multiple genetic mutations.

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].