WordNet

lack of success; "he felt that his entire life had been a failure"; "that year there was a crop failure"
loss of ability to function normally; "kidney failure"
an act that fails; "his failure to pass the test"
an unexpected omission; "he resented my failure to return his call"; "the mechanics failure to check the brakes"
a person with a record of failing; someone who loses consistently (同)loser, nonstarter, unsuccessful person
an event that does not accomplish its intended purpose; "the surprise party was a complete failure"

PrepTutorEJDIC

〈U〉(…における)『失敗』,不成功《+『in』+『名』(do『ing』)》 / 〈C〉失敗者,落後者;失敗した企て,不できなもの / 〈U〉〈C〉怠慢,不履行 / 〈U〉〈C〉(…の)不足,欠乏《+『of』+『名』》 / 〈U〉〈C〉(…の)破産《+『of』+『名』》 / 〈U〉(…の)『衰弱』,減退《+『in』(『of』+『名』》
肺の;肺を冒す

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/04/03 13:20:33」(JST)

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Respiratory failure is inadequate gas exchange by the respiratory system, with the result that levels of arterial oxygen, carbon dioxide or both cannot be maintained within their normal ranges. A drop in blood oxygenation is known as hypoxemia; a rise in arterial carbon dioxide levels is called hypercapnia. The normal reference values are: oxygen PaO₂ less than 80 mmHg (11 kPa), and carbon dioxide PaCO₂ greater than 45 mmHg (6.0 kPa). Classification into type I or type II relates to the absence or presence of hypercapnia respectively.

Types[edit]

Type 1[edit]

Type 1 respiratory failure is defined as hypoxia without hypercapnia, and indeed the P_aCO₂ may be normal or low. It is typically caused by a ventilation/perfusion (V/Q) mismatch; the volume of air flowing in and out of the lungs is not matched with the flow of blood to the lungs. The basic defect in type 1 respiratory failure is failure of oxygenation characterized by:

P_aO₂	low (< 60 mmHg (8.0 kPa))
P_aCO₂	normal or low (<50 mmHg (6.7 kPa))
P_A-aO₂	increased

This type of respiratory failure is caused by conditions that affect oxygenation such as:

Low ambient oxygen (e.g. at high altitude)
Ventilation-perfusion mismatch (parts of the lung receive oxygen but not enough blood to absorb it, e.g. pulmonary embolism)
Alveolar hypoventilation (decreased minute volume due to reduced respiratory muscle activity, e.g. in acute neuromuscular disease); this form can also cause type 2 respiratory failure if severe
Diffusion problem (oxygen cannot enter the capillaries due to parenchymal disease, e.g. in pneumonia or ARDS)
Shunt (oxygenated blood mixes with non-oxygenated blood from the venous system, e.g. right-to-left shunt)

Type 2[edit]

Hypoxia (PaO2 <8kPa) with hypercapnia (PaCO2 >6.0kPa).

The basic defect in type 2 respiratory failure is characterized by:

P_aO₂	decreased (< 60 mmHg (8.0 kPa))
P_aCO₂	increased (> 50 mmHg (6.7 kPa))
P_A-aO₂	normal
pH	decreased

Type 2 respiratory failure is caused by inadequate alveolar ventilation; both oxygen and carbon dioxide are affected. Defined as the build up of carbon dioxide levels (P_aCO₂) that has been generated by the body but cannot be eliminated. The underlying causes include:

Increased airways resistance (chronic obstructive pulmonary disease, asthma, suffocation)
Reduced breathing effort (drug effects, brain stem lesion, extreme obesity)
A decrease in the area of the lung available for gas exchange (such as in chronic bronchitis)
Neuromuscular problems (Guillain-Barré syndrome,^[1] myasthenia gravis, motor neurone disease)
Deformed (kyphoscoliosis), rigid (ankylosing spondylitis), or flail chest.^[1]

Treatment[edit]

Mechanical Ventilator

Emergency treatment follows the principles of cardiopulmonary resuscitation. Treatment of the underlying cause is required. Endotracheal intubation and mechanical ventilation is required in severe respiratory failure (PaO2 less than 50 mmHg). Respiratory stimulants such as doxapram are rarely used, and if the respiratory failure resulted from an overdose of sedative drugs such as opioids or benzodiazepines, then the appropriate antidote such as naloxone or flumazenil will be given.

References[edit]

^ ^a ^b Burt, Christiana C.; Arrowsmith, Joseph E. (1 November 2009). "Respiratory failure". Surgery (Oxford) 27 (11): 475–479. doi:10.1016/j.mpsur.2009.09.007. Cite uses deprecated parameters (help)

UpToDate Contents

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English Journal

Sgk1 sensitivity of Na(+)/H (+) exchanger activity and cardiac remodeling following pressure overload.

Voelkl J, Lin Y, Alesutan I, Ahmed MS, Pasham V, Mia S, Gu S, Feger M, Saxena A, Metzler B, Kuhl D, Pichler BJ, Lang F.SourceDepartment of Physiology, University of Tübingen, Gmelinstr. 5, 72076, Tübingen, Germany.
Basic research in cardiology.Basic Res Cardiol.2012 Mar;107(2):1-15. Epub 2012 Jan 3.
Sustained increase of cardiac workload is known to trigger cardiac remodeling with eventual development of cardiac failure. Compelling evidence points to a critical role of enhanced cardiac Na(+)/H(+) exchanger (NHE1) activity in the underlying pathophysiology. The signaling triggering up-regulation
PMID 22212557

Pulmonary complications of renal disorders.

Turcios NL.SourceRobert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
Paediatric respiratory reviews.Paediatr Respir Rev.2012 Mar;13(1):44-9. Epub 2011 May 11.
To manage patients with diseases of the lungs and the kidneys, one must first understand the relationship between respiratory and renal function. In treating acute renal failure (ARF), the clinician often must contend with respiratory manifestations of volume overload and metabolic acidosis. Mechani
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Out of hours multidetector computed tomography pulmonary angiography are specialist resident reports reliable?

Jakanani GC, Botchu R, Gupta S, Entwisle J, Bajaj A.SourceGlenfield Hospital, Groby Road, Leicester, United Kingdom.
Academic radiology.Acad Radiol.2012 Feb;19(2):191-5.
RATIONALE AND OBJECTIVES: The purposes of this study were to assess the accuracy of trainee radiologists' reports for computed tomographic pulmonary angiographic (CTPA) imaging and to determine agreement or discrepancy with final verified consultant reports.MATERIALS AND METHODS: A total of 100 cons
PMID 22212421

Japanese Journal

肺高血圧症の病態生理からみた治療戦略 (特集肺高血圧症治療の最前線)

鳥羽慶栄
日本胸部臨床 74(3), 263-274, 2015-03
NAID 40020381339

Diffuse Alveolar Hemorrhage in a Patient with Acute Poststreptococcal Glomerulonephritis Caused by Impetigo

, , , , , , , ,
Internal Medicine 54(8), 961-964, 2015
… We herein report a case of pulmonary renal syndrome with nephritis in a 17-year-old boy with diffuse alveolar hemorrhage (DAH) associated with acute poststreptococcal glomerulonephritis (APSGN). … Respiratory failure progressed, and high-dose methylprednisolone therapy was administered; … the respiratory failure regressed immediately after the onset of therapy. … This case demonstrates the effects of high-dose methylprednisolone therapy in improving respiratory failure. …
NAID 130005065257

Progressive Diffuse Pulmonary Interstitial Opacities due to Complications of Pulmonary Tumor Emboli: An Autopsy Case Report

, , , , ,
Internal Medicine 54(8), 955-960, 2015
… A transbronchial lung biopsy revealed tumor cell emboli in the pulmonary arteries. … however, the interstitial opacities progressively worsened and he died of acute respiratory failure. … An autopsy revealed extensive pulmonary tumor embolisms (PTE) with associated ischemic damages, e.g., infarctions, alveolar wall thickening with cuboidal metaplasia, hemorrhage, and diffuse alveolar damage. …
NAID 130005065247