Causes of type 2 respiratory failure

Respiratory Failure – Facts and Background Information

This condition represents a disease of the lungs. Our respiratory system is comprised of a gas-exchanging organ (the lungs) and a ventilatory pump (the thorax and all the respiratory muscles). When it comes to causes of respiratory failure, it occurs as a direct consequence of the failure of one of these organs, or both at the same time.

A more detailed and picturesque description looks like this – once the overall lung gas exchange is to a great extent hindered, which causes oxygen blood levels to drop or, as it is commonly referred to, hypoxemia.

Respiratory Failure – Categorization

There exist two distinct types of respiratory failure, namely respiratory failure Type 1 and respiratory failure Type 2. Respiratory Failure Type 1 occurs when there is not enough oxygen and its levels become dangerously low, whereas carbon dioxide levels remain either normal or also low.

Respiratory Failure Type 2 occurs when there is not enough oxygen, whereas, on the other hand, the levels of carbon dioxide are heightened.

Statistics and Risks

When it comes to the overall statistics, it should be emphasized that this condition belongs to the group of fairly frequently occurring ones. The main reason for this is that it may occur as a side effect of just about any lung disease, or multi-organ failure.

Among the most common culprits for the occurrence of Respiratory Failure Type 1 is such as various diseases that bring damage to the lung tissue (e.g. pulmonary edema, pneumonia, chronic pulmonary fibrosing alveolitis, and acute respiratory distress syndrome).

As far as Respiratory Failure Type 2 is concerned, the causes include chronic obstructive pulmonary disease (the most common culprit), respiratory muscle weakness (such as the Gullian-Barre syndrome), central depression of the respiratory center (such as the OD from heroin) and deformities of the chest wall, to name but those most frequent and serious ones. The methods and techniques employed for discovering and diagnosing respiratory failure include, such as tidal volume and vital capacity, blood gas analyses, and pulse oximetry.

The respiratory system allows gas exchange between the environment and the body, facilitating the process of aerobic metabolism. Specifically, the respiratory system provides oxygen and removes carbon dioxide from the body. The inability of the respiratory system to perform either or both of these tasks results in respiratory failure. Type 1 respiratory failure occurs when the respiratory system cannot adequately provide oxygen to the body, leading to hypoxemia. Type 2 respiratory failure occurs when the respiratory system cannot sufficiently remove carbon dioxide from the body, leading to hypercapnia.

Respiratory failure can occur if there is an abnormality with any component of the respiratory system. Components of the respiratory system include the upper and lower respiratory tracts, the central and peripheral nervous systems, in addition to the chest wall and muscles of respiration.
Respiratory failure (RF) is a syndrome caused by a multitude of pathological states; therefore, the epidemiology of this disease process is difficult to ascertain. In 2017 in the United States of America, however, the incidence of respiratory failure was found to be 1,275 cases per 100,000 adults. The case definition used in this study included all diagnosis codes that included respiratory failure as a component.
Acute myocardial infarction-related (AMI-RF): Between the years 2000 and 2014, 439,436 admissions due to AMI-RF were noted in 57% and required mechanical ventilation in 43% of total cases.
Acute respiratory failure due to acute respiratory distress syndrome (ARDS) ranges in incidence from 10-80/100,000/y based on where it is recorded worldwide. This is partly due to different practices and thresholds for intubation in these cases and the use of different definitions of ARDs. According to one report, it is estimated that 10% of all patients admitted to ICU and 23% of mechanically ventilated patients meet ARDS criteria.
Acute respiratory failure related to Coronavirus (COVID-19): It is estimated early in the COVID-19 pandemic that up to 79% of hospitalized patients developed respiratory failure requiring invasive mechanical ventilation.
The distinguishing characteristic of Type 1 respiratory failure is a partial pressure of oxygen (PaO2)
Hypercapnic respiratory failure is defined as an increase in arterial carbon dioxide (CO2) (PaCO)> 45 mmHg with a pH

Treatment of respiratory failure should be directed towards the underlying cause while providing support with oxygenation and ventilation, if necessary. The treatment includes supportive measures and treatment of the underlying cause. However, the initial steps in managing patients with acute respiratory failure should start by assessing the airway, breathing, and circulation (ABC). Supportive measures depend on patent airways to maintain adequate oxygenation, ventilation, and correction of blood gas abnormalities.

✓ Fact confirmed: Respiratory Failure Vincent S. Mirabile, Eman Shebl, Abdulghani Sankari, Bracken Burns; May 29, 2023.

Treatment

As far as the treatment is concerned, in most cases, because of its effectiveness, the following methods and techniques are most often employed – secretion control (i.e. physiotherapy), lung infection treatment (antibiotics therapy), supplemental oxygen (oxygen mask used), constant controlling of the obstruction of the airways (by the employment of corticosteroids and bronchodilators), limitation of the pulmonary edema, and respiratory muscles load reduction.