There seems to be some confusion with regards to the correctness of this video and what some people are saying in the comments section. Please allow me to clarify (with the help of the Oxford Handbook of Clinical Medicine). Type 1 respiratory failure: Defined as: hypoxia (PaO2
Thanks for the response. I hadnt thought about the solubility of CO2! i also asked my physiology tutor and he mentioned the fact that you can maintain a high O2 with little ventilation (so O2 stays O.K. with obstruction - type 2)
You miss the most important point out. It is all about CO2 bein more soluable than O2 so CO2 diffuses rapidly accross the alveoli so even with V/Q mismatch it hardly affects the amount of CO2 in the alveoli at all. If we imagine that CO2 diffuses infinitely fast, the affecting factor is clearance of air containint CO2 out of the lungs. Therefore it is the RR + TV which greatly affect the CO2 clearance and therefore the PaCO2.
I may be wrong, but I'm guessing the Q is used to represent circulation (cir-Q-lation), just a thought from someone who grew up hearing "remember your Ps and Qs" (please and thank you (than-Q))
This is wrong...Type 1 respiratory failure is low PaO2 and normal or low PaCO2--- it's not simply hypoxemic as if there is a blockage then surely it would impair co2 transport out of the capillaries in to the alveoli too---resulting in increased CO2 retention so hypercapnia also. In fact in type 1 you have low O2 and normal or low PaCO2 because the CO2 is more soluble than oxygen and so when gas exchange is impaired because of a ventilation/perfusion or cardiac shunt the oxygen is much more affected than the CO2 hence you get low oxygen. However as for the CO2, it remains normal or later falls. It later falls in response to the increased hyperventilation compensation as a result of the low oxygen levels.
In type 1 resp failure (@4minutes), why doesn't the fluid in the alveoli prevent CO2 from diffusing out? I don't understand why CO2 remains normal. Equally, in type 2 resp failure, why doesn't the obstruction prevent oxygenation?
Thanks for the questions, Lucy. I'm certainly not the expert on gas mechanics, but I believe it may have something to do with the fact that CO2 is more water soluble than O2. This allows it to diffuse through better. Again, for your second question it would probably be best to ask a physiologist, I can only speak from my experience in working with severe asthmatics or COPD'ers. In these patients, both CO2 and oxygenation are affected. You get hypercapnia and hypoxia.
Does anyone kniws how it can be that you can breath air(leftovers ) out easily but absolutely can not breath air in? 20 seconds After epidural injection prior C section.
So in Type I respiratory failure, sometimes also called hypoxic respiratory failure, the inability of oxygen to diffuse through the fluid results in the low O2. In Type II resp failure, sometimes called hypercapnic resp failure, you get the high CO2 as well as low O2.
There seems to be some confusion with regards to the correctness of this video and what some people are saying in the comments section. Please allow me to clarify (with the help of the Oxford Handbook of Clinical Medicine).
Type 1 respiratory failure:
Defined as: hypoxia (PaO2
Thank you for the wonderful explanation/clarification.
Thank you! It helps me a lot. I am a 2nd year medstud
thank you!
Thanks it's great
That was wonderful. Thank you
اللهم صل على سيدنا محمد وعلى اله وصحبه وسلم تسليما كثيرا عدد خلقك و رضا نفسك وزنة عرشك ومداد كلماتك و عدد ما كان وعدد ما سيكون وعدد الحركات والسكون
This is a good introduction to the topic of respiratory failure. Thank you.
Thanks for the response. I hadnt thought about the solubility of CO2! i also asked my physiology tutor and he mentioned the fact that you can maintain a high O2 with little ventilation (so O2 stays O.K. with obstruction - type 2)
You miss the most important point out. It is all about CO2 bein more soluable than O2 so CO2 diffuses rapidly accross the alveoli so even with V/Q mismatch it hardly affects the amount of CO2 in the alveoli at all. If we imagine that CO2 diffuses infinitely fast, the affecting factor is clearance of air containint CO2 out of the lungs. Therefore it is the RR + TV which greatly affect the CO2 clearance and therefore the PaCO2.
w o t
I may be wrong, but I'm guessing the Q is used to represent circulation (cir-Q-lation), just a thought from someone who grew up hearing "remember your Ps and Qs" (please and thank you (than-Q))
great great i hope to see next lecture(02) about respiratoy failure
This is wrong...Type 1 respiratory failure is low PaO2 and normal or low PaCO2--- it's not simply hypoxemic as if there is a blockage then surely it would impair co2 transport out of the capillaries in to the alveoli too---resulting in increased CO2 retention so hypercapnia also. In fact in type 1 you have low O2 and normal or low PaCO2 because the CO2 is more soluble than oxygen and so when gas exchange is impaired because of a ventilation/perfusion or cardiac shunt the oxygen is much more affected than the CO2 hence you get low oxygen. However as for the CO2, it remains normal or later falls. It later falls in response to the increased hyperventilation compensation as a result of the low oxygen levels.
Second year medical student.
+irtaza ali Thanks for the comment. I did make a lot of simplifications, as you can tell.
How is it type 1 Resp.failure in Fibrosis then?
Great video. Short and sweet!
In type 1 resp failure (@4minutes), why doesn't the fluid in the alveoli prevent CO2 from diffusing out? I don't understand why CO2 remains normal.
Equally, in type 2 resp failure, why doesn't the obstruction prevent oxygenation?
In type 1 hypoxemia occurs but in type 2 hypoxemia and hypercapnia both occur..this classification is based on presences or absence of carbon dioxide
Because CO2 is highly diffusible ... that's why it comes out of lungs easily
Thanks for the questions, Lucy. I'm certainly not the expert on gas mechanics, but I believe it may have something to do with the fact that CO2 is more water soluble than O2. This allows it to diffuse through better.
Again, for your second question it would probably be best to ask a physiologist, I can only speak from my experience in working with severe asthmatics or COPD'ers. In these patients, both CO2 and oxygenation are affected. You get hypercapnia and hypoxia.
Thank you!
It is helpful
very well explained in a easy and understanding way.. thank you so much... keep up ur work coming
I think this is a very confusing video. In type 1, why won't CO2 also be unable to diffuse out? Won't there be hypercapnea (type 2)?
Thanks for your videos. They really help explain things.
So clear THANKS 🙏
Hi doctor nice 👍 video. V good teacher . Which software you use to do drawings?
Excellent
Thank you!!
👍 unreal cheers
Thank you.
thanks for the video.
Does anyone kniws how it can be that you can breath air(leftovers ) out easily but absolutely can not breath air in? 20 seconds After epidural injection prior C section.
Why has this video got so many likes? It barely explains anything - what happens to the C02 levels in type 1 and the O2 levels in type 2 and why...
exactly what i was whispering to myself lol
The Aa gradient would be high.
Aa gradient?is it high low or normal?
don28 type 1 high
Type 2 normal
Sorry, I labeled it Vent Settings Explained. I renamed it Breathing 02: Vent Settings Explained.
loved it
Nice tutorial, thanks :)
My lungs are shutting down I cant breath at all
Spend on a microphone maybe!
This is sloppy sorry. Some parts are even opposite to what I've learned smfh
So in Type I respiratory failure, sometimes also called hypoxic respiratory failure, the inability of oxygen to diffuse through the fluid results in the low O2. In Type II resp failure, sometimes called hypercapnic resp failure, you get the high CO2 as well as low O2.