[Physiopathology of chronic respiratory insufficiency].
The host of chronic respiratory abnormalities responsible for an abnormal hematosis or for a handicap can be termed generically as chronic respiratory insufficiency. Hypoxemia can be the consequence of perturbations of oxygen transfer (fibrosis), of abnormal ventilation-perfusion ratios (venous admixture, chronic obstructive pulmonary disease [COPD]), or of hypoventilation (neuromuscular diseases). Hypercapnia can stem from hypoventilation (neuromuscular diseases), or from abnormal ventilation-perfusion ratios (dead space effect) (COPD). An imbalance between the capacity of the respiratory muscle to produce negative inspiratory pressures and the load they are faced with is a source of hypercapnia, and of dyspnoea and handicap independently of hematosis (COPD, neuromuscular diseases). The effects of hypoxemia on cellular functions make chronic respiratory insufficiency a systemic disease.
Similowski
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Service de pneumologie et réanimation Groupe hospitalier La Pitié-La Salpêtrière 75651 Paris. thomas.similowski@psl.ap-hop-paris.fr
D002908:Chronic Disease; D006233:Persons with Disabilities; D004417:Dyspnea / Q000503:physiopathology*; D006801:Humans; D006935:Hypercapnia / Q000209:etiology / Q000503:physiopathology; D000860:Hypoxia / Q000209:etiology / Q000503:physiopathology; D008173:Lung Diseases, Obstructive / Q000150:complications; D009468:Neuromuscular Diseases / Q000150:complications; D012131:Respiratory Insufficiency / Q000503:physiopathology*