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MCV/Q, Medical College of Virginia Quarterly
I suppose it is appropriate that we come to respiratory failure at the end of a longish day. The definition of respiratory failure has an interesting history. Barcroft, 30 to 40 years ago, understood respiratory failure as a tissue phenomenon. He would have described cyanide poisoning to you as an example of respiratory failure. "Ventilatory failure" came into fashion but is not a very good term because total ventilation may be fine but gas exchange may be very poor. Europeans have invented various terms like "global insufficiency," which sounds very impressive in German, but always sounds to me more like a term from the Pentagon than a medical or physiological definition. I prefer to use the term "respiratory failure" to mean everything related to disordered gas tensions; but if you attempt a precise definition, you run into unexpected difficulties.
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