Chapter 20 - Ventilatory failure
Review articleOpen access
Abstract:

Publisher SummaryThis chapter reviews most of the causes of failure of ventilation. The ventilatory failure is defined as a pathological reduction of the alveolar ventilation below the level required for the maintenance of normal arterial blood gas tensions. Mean of the normal arterial PCO2 is 5.1 kPa with 95% limits of ± 1.0 kPa. The normal arterial PO2 is more difficult to define as it decreases with age. Furthermore, the arterial PO2 is strongly influenced by the concentration of oxygen in the inspired gas and, therefore, cannot be interpreted unless the inspired oxygen concentration is known. The arterial PO2 is also strongly influenced by shunting and the adequacy of ventilation is, therefore, best defined by the arterial PCO2. A wide variety of drugs can cause central apnea or respiratory depression, and these include opiates, barbiturates, and all anesthetic agents. The reflex apnea can follow noxious stimuli but the Hering–Breuer inflation reflex is weak in man and lung inflation does not normally cause apnea.

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