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Journal of Intensive Care Medicine
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Extrapulmonary Causes of Respiratory Failure

Melvin R. Pratter, MD

University of Massachusetts Medical School, Pulmonary Medicine Division, Worcester, MA 01605

Richard S. Irwin, MD

University of Massachusetts Medical School, Pulmonary Medicine Division, Worcester, MA 01605

The causes of respiratory failure can be divided into two main groups: extrapulmonary and pulmonary. Extrapulmonary causes of respiratory failure include conditions that exclusively or primarily cause respiratory failure by their effect on structures other than the lungs (i.e., the extrapulmonary compartment). To place the topic of extrapulmonary respiratory failure into perspective, we briefly review normal and abnormal gas exchange and then examine how one can use this information to suspect or confirm the diagnosis of an extrapulmonary cause of respiratory failure. We then review the individual causes of extrapulmonary respiratory failure. These have been divided into two main functional categories: (1) those that involve a decrease in normal force generation, and (2) those that involve an increase in resistance to (bulk flow) ventilation. We then briefly consider the treatment of these disorders from a respiratory point of view.

Journal of Intensive Care Medicine, Vol. 1, No. 4, 197-217 (1986)
DOI: 10.1177/088506668600100405
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