The primary cause of cardiopulmonary arrest in children is unrecognized respiratory failure. Clinicians must recognize respiratory failure in its early stage of presentation and know the appropriate clinical interventions.

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Respiratory failure is a condition in which the respiratory system fails in oxygenation or carbon dioxide elimination or both. There are 2 types of impaired gas exchange: (1) hypoxemic respiratory failure, which is a result of lung failure, and (2) hypercapnic respiratory failure, which is a result of respiratory pump failure (Figure 1). (1)(2)

In hypoxemic respiratory failure, ventilation-perfusion (⁠⁠) mismatch results in the decrease of Pao2) to below 60 mm Hg with normal or low Paco2. (1) In hypercapnic respiratory failure, mismatch results in the increase of Paco2 to above 50 mm...

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