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  • Respiratory failure is a life-threatening impairment of oxygenation or carbon dioxide elimination that affects breathing function or the lungs themselves, and can result in failure of the lungs to function properly. Two main pathophysiological etiologies (may occur singly, or in combination): inadequate oxygenation (impaired gas exchange); inadequate carbon dioxide elimination (decreased ventilation resulting in a rise in PaCO2). Common precipitating conditions: acute exacerbations of asthma and chronic obstructive pulmonary disease; overdoses of drugs that suppress ventilatory drive; and conditions that cause respiratory muscle weakness (e.g., Guillain-Barre syndrome, myasthenia gravis, botulism). Typical signs and symptoms: dyspnea; tachypnea; use of accessory muscles of respiration; tachycardia; diaphoresis; cyanosis; altered consciousness; without treatment, eventually obtundation, respiratory arrest, and death. Diagnostic measures: patient observation and clinical evaluation; arterial blood gases; and chest x-ray. Treatment includes: correction of underlying cause; supplemental oxygen; control of secretions; and ventilatory assistance.
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