Acute Respiratory Failure in the Patient with Chronic Airflow Obstruction

  • Samuel V. Spagnolo


Respiratory failure occurs when gas exchange is impaired. Mild degrees of respiratory failure with hypoxemia or hypercarbia may be present for many years without apparent serious physiologic consequences because of the body’s normal compensatory mechanisms. The severity of respiratory failure and the need for urgent therapeutic intervention depend on the rate and degree of deterioration in gas exchange as reflected in the arterial blood gases (ABG). Life-threatening, acute respiratory failure occurs when gas exchange is deteriorating rapidly, with accelerated alterations in acid-base chemistry. Abrupt alterations in gas exchange (occurring over minutes to several days) that lower the PaO2 below 55 mm Hg or lower the pH below 7.30 (by raising the PaCO2 above 50 mm Hg) require rapid and aggressive therapy.


Chronic Obstructive Pulmonary Disease Pulmonary Artery Pressure Acute Respiratory Failure Nasal Cannula Alveolar Hypoxia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Albert RK, Martin TR, Lewis SW: Controlled clinical trial of Methylprednisolone in patients with chronic bronchitis and acute respiratory insufficiency. Ann Intern Med 92:753–758, 1980.PubMedGoogle Scholar
  2. 2.
    Aubier M, Murciano D, Viires N, Lecocuicy Y, Palacios S, Pariente R: Increased ventilation caused by improved diaphragmatic efficiency during aminophylline infusion. Am Rev Respir Dis 127:148–154, 1983.PubMedGoogle Scholar
  3. 3.
    Kawakami Y, Kishi J, Yamamoto H, Miyamoto K: Relation of oxygen delivery, mixed venous oxygenation, and pulmonary hemodynamics to prognosis in chronic obstructive pulmonary disease. N Engl J Med 308:1045–1049, 1983.PubMedCrossRefGoogle Scholar
  4. 4.
    Nicotra MB, Rivera M, Awe RJ: Antibiotic therapy of acute exacerbation of chronic bronchitis. A controlled study using tetracycline. Ann Intern Med 97:18–21, 1982.PubMedGoogle Scholar
  5. 5.
    Snider GL (ed): Clinics in Chest Medicine, Emphysema, Vol 4. Philadelphia, WB Saunders, September, 1983.Google Scholar
  6. 6.
    Sturani C, Bassein L, Schiavina M, Gunella G: Oral nifedipine in chronic cor pulmonale secondary to severe chronic obstructive pulmonary disease (COPD)—Short- and long-term hemodynamic effects. Chest 84:135–142, 1983.PubMedCrossRefGoogle Scholar
  7. 7.
    Blair GP, Light RW: Treatment of chronic obstructive pulmonary disease with corticosteroids. Comparison of daily vs. alternate day therapy. Chest 86:524–528, 1984.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Samuel V. Spagnolo
    • 1
    • 2
  1. 1.Division of Pulmonary Diseases and Allergy, Department of MedicineGeorge Washington University School of Medicine and Health SciencesWashingtonUSA
  2. 2.Pulmonary Disease SectionVeterans Administration Medical CenterWashingtonUSA

Personalised recommendations