Respiratory failure classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  M. Khurram Afzal, MD [2]

## Overview

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Respiratory failure may be classified into several subtypes as follows; Type I, Type II, Type III, Type IV.

## Classification

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The classification of respiratory failure is as follows:[1]

| Respiratory Failure|

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Type I|

| Type II|

| Type III|

| Type IV

Hypoxemic|

| Hypercapnic|

| Peri-operative|

| Shock

### Classification based on A-a gradient

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Respiratory failure patients may have a normal or increased A-a gradient depending upon the etiology of the respiratory failure. The following table outlines the major characteristics:

| Respiratory Failure-decreased SaO2|

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| Normal A-a gradient|

| Increased A-a gradient

| Normal PaCO2|

| Increased PaCO2|

| Hypoxemia does not correct with 100% O2|

| Hypoxemia corrects with 100% O2

| Decreased FiO2 or decreased PiO2|

| Hypoventilation (sedation, COPD, asthma, diaphragmatic paralysis or Neuromuscular disease)|

| True shunt (Left to right shunts, CHF, pneumonia, atelectasis)|

| Vascular disease (pulmonary embolism), airway disease (COPD, asthma), alveolar filling (CHF, pneumonia)

## References

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1. ↑ Hall, Jesse (2015). "CHAPTER 43: The Pathophysiology and Differential Diagnosis of Acute Respiratory Failure". Principles of critical care. New York: McGraw-Hill Education. ISBN 0071738819.

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