The difference between type 1 respiratory failure and type 2 respiratory failure

Respiratory failure, also known as respiratory failure, is common in the respiratory system. Respiratory failure may occur within days or hours, and the condition is relatively serious. In this case, you need to pay attention to certain conditioning and rectification to avoid some complications. It is very helpful for all aspects of the body. In addition, you also need to understand what is the difference between type 1 respiratory failure and type 2 respiratory failure?

The difference between type 1 respiratory failure and type 2 respiratory failure should be noted in differential diagnosis

Core Tip: Respiratory failure is a common disease and complication in respiratory medicine. Acute respiratory failure can occur within days or hours and is a serious condition that requires timely rescue to save the patient's life. Chronic respiratory failure develops slowly over weeks or longer, and the body can produce a series of compensatory responses. Respiratory failure not only causes breathing difficulties, but also often affects other organs. Therefore, clearly distinguishing the types of respiratory failure is important for timely diagnosis and treatment guidance.

Respiratory failure is a disorder of lung ventilation and gas exchange due to various reasons, which results in the inability to carry out effective gas exchange, further leading to human hypoxia with or without carbon dioxide retention, and then causing a series of clinical syndromes of physiological function and metabolic disorders. The diagnostic criteria for respiratory failure are: PaO2 < 60 mmHg or PaCO2 > 50 mmHg when breathing air at rest at sea level. According to pathophysiology and arterial blood gas analysis, it can be divided into type I respiratory failure and type II respiratory failure. The following introduces the difference between type I respiratory failure and type II respiratory failure.

1. Based on arterial blood gas analysis

Type I respiratory failure, hypoxia but no CO2 retention, seen in cases of ventilation dysfunction. Type II respiratory failure is caused by lack of O2 and CO2 retention due to insufficient alveolar ventilation, which is common in chronic obstructive pulmonary disease (COPD), upper airway obstruction, respiratory muscle dysfunction, etc. Type I respiratory failure is characterized by PaO2 < 60 mmHg and normal or decreased PaCO2; type II respiratory failure is characterized by PaO2 < 60 mmHg and PaCO2 > 50 mmHg.

2. Treatment methods.

Type I respiratory failure requires high-flow oxygen therapy, while type II respiratory failure must be treated with low-flow oxygen therapy. Type I respiratory failure is caused by hypoxia but no carbon dioxide retention, mainly due to insufficient oxygen, such as airway obstruction, while the body's ability to eliminate carbon dioxide is still there. Type II respiratory failure is characterized by insufficient oxygen intake and poor carbon dioxide elimination. When high oxygen therapy is performed, the high oxygen concentration will inhibit the respiratory center, so low-concentration oxygen therapy is required.

3. Oxygen therapy flow

Type I respiratory failure oxygen flow should be >3 L/min (concentration >30%)

Type II respiratory failure oxygen flow should be <3 L/min (concentration <30%)

Respiratory failure is often accompanied by a history of bronchial, lung, pleural, pulmonary vascular, cardiac, neuromuscular or severe organic diseases, and respiratory tract infection is a common cause. The clinical symptoms are mostly dyspnea, shortness of breath, psychoneurological symptoms, and cardiovascular system symptoms. The diagnosis is mainly based on blood gas analysis, and the differential typing refers to the above blood gas analysis results. Only by clearly classifying respiratory failure can we provide correct guidance on the method of oxygen administration. In addition, maintaining airway patency, preventing and treating multiple organ dysfunction, and actively treating the primary disease are also principles for treating respiratory failure.