Related Experiment Videos
Respiratory failure
1Dept of Critical Care, University of Athens Medical School, Evangelismos Hospital, Athens, Greece. croussos@cc.uoa.gr
The European Respiratory Journal. Supplement
|November 19, 2003
Summary
Respiratory failure, characterized by hypoxemia or hypercapnia, results from lung or pump issues. Chronic hypercapnic respiratory failure may stem from a "natural wisdom" adaptation to respiratory load, leading to reduced ventilation.
Area of Science:
- Respiratory Medicine
- Physiology
Background:
- Respiratory failure is categorized into lung failure (hypoxemia) and pump failure (hypercapnia).
- Hypercapnic respiratory failure can be acute or chronic, stemming from various factors including CNS depression, mechanical defects, and respiratory muscle fatigue.
Purpose of the Study:
- To elucidate the pathophysiological mechanisms underlying hypercapnic respiratory failure, particularly chronic carbon dioxide retention.
- To explore the
- natural wisdom
- hypothesis regarding adaptation to respiratory loads.
Main Methods:
- The study reviews existing literature and proposes a leading hypothesis based on recent work.
- The proposed mechanism involves a threshold inspiratory load triggering muscle injury and an adaptive response.
Main Results:
- Reduced alveolar ventilation is a common pathophysiological denominator in hypercapnic respiratory failure.
- The
- natural wisdom
- theory suggests a trade-off between maintaining normal gas tensions and avoiding respiratory muscle fatigue.
- An adaptive response involving cytokine production and modulation of respiratory controllers is hypothesized to cause alveolar hypoventilation and CO2 retention.
Conclusions:
- Chronic carbon dioxide retention may result from an adaptive response to excessive respiratory load, aimed at preventing muscle damage.
- This adaptive response, involving cytokine signaling and neuro-modulation, ultimately leads to alveolar hypoventilation.