Hypoxemic respiratory failure

Sznadjer, J.I., Fraiman, A. and Hall, J.B. (1989). Increased hydrogen peroxide in the expired breath of patients with acute hypoxemic respiratory failure. Chest 96, 606-612. 

Local administration of NO to the lungs has been shown to reverse pulmonary hypertension in animal models [103], importantly with no systemic side effects. This is likely to be as a result of surplus NO being removed as nitrosyl-hemoglobin [104]. Such advantages of gaseous NO were first reported in 1991 [105, 106]. In 1999 and 2001 NO gas was approved as a drug in the USA and European Union, for treating hypoxemic respiratory failure in infants [107]. 

A 72-year-old man developed hypoxemic respiratory failure while taking amiodarone 300 mg/day (74). He had no history of lung disease. His CT scan was similar to that of the first patient. He responded to treatment with corticosteroids. 

Dada L, Sznajder Jl. Mechanisms of pulmonary edema clearance during acute hypoxemic respiratory failure Role of the Na,K-ATPase. Crit Care Med 2003 31(suppl) S248-252. 

Abman, S. H., Griebel, J. L., Parker, D. K., Schmidt, J. M., Swanton, D., and Kinsella, J. P. (1994). Acute effects of inhaled nitric oxide in children with severe hypoxemic respiratory failure./. Pediatr. 124, 881-884. 

Respiratory failure may be classified as hypoxemic (type 1) or hypercapnic (type II or ventilatory failure) (3), either of which may be acute and chronic. Hypoxemic respiratory failure is due to failure of the lungs, caused by acute (cardiogenic pulmonary edema, pneumonia, acute respiratory distress syndrome) or chronic (emphysema, interstitial limg disorders) diseases (Tables 1 and 2). It is characterized by hypoxemia with normocapnia or hypocapnia. In these conditions central respiratory drive is high and there is sufficient alveolar ventilation (VA) to eliminate CO2 and prevent hypercapnia. 

III. Pathophysiology of Chronic Respiratory Failure A. Hypoxemic Respiratory Failure... 

Hall JB, Schmidt GA, Wood LD. Acute hypoxemic respiratory failure. In Murray JF, Nadel JA, eds. Textbook of Respiratory Medicine. Philadelphia Saunders, 2000 2413-2442. 

Novak RA, Shumaker L, Snyder JV, et al. Do periodic hyperinflations improve gas exchange in patients with hypoxemic respiratory failure Crit Care Med 1987 15 1081-1085. 

Meduri GU, Turner RE, Abou-Shala N, et al. Noninvasive positive pressure ventilation via face mask. First-line intervention in patients with acute hypercapnic and hypoxemic respiratory failure. Chest 1996 109 179-193. 

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