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Respiratory failure
Is asthma considered respiratory failure?
Asthma and respiratory failure are two distinct concepts. Asthma is a disease, whereas respiratory failure is a clinical outcome resulting from a series of diseases. During an acute asthma attack, there is also a possibility of respiratory failure occurring, and in severe cases, it can lead to serious respiratory failure requiring interventions like tracheal intubation and mechanical ventilation. Therefore, acute asthma attacks require active intervention. Treatments often include nebulized inhalation of short-acting bronchodilators and even intravenous administration of corticosteroids to handle the acute episode. Short-term intravenous use of corticosteroids can also help in controlling the acute attack.
Precursors of respiratory failure
Respiratory failure can be a very acute condition, or it may evolve gradually due to chronic diseases. The basic precursors of respiratory failure generally include hypoxia or hypercapnia. In the early stages of hypoxia, patients may experience excitement or irritability, characterized by rapid breathing and possibly sweating due to the effort of breathing. Symptoms include accelerated breathing and hypoxia; the patient’s lips may also turn blue. If the level of carbon dioxide increases, once past the initial period of excitement and as the hypoxia worsens, the person may become listless. Gradually, their consciousness may become unclear, manifesting as drowsiness or possibly even coma.
Causes of CO2 retention in respiratory failure
Respiratory failure manifests as hypoxia and the retention of carbon dioxide. The main cause of carbon dioxide retention is pathological changes in the respiratory system, such as chronic obstructive pulmonary disease with respiratory failure, status asthmaticus, pulmonary heart disease, lung cancer, etc. Some neuropathies that cause paralysis of the respiratory muscles can lead to respiratory dysfunction, resulting in the retention of carbon dioxide in the body, affecting normal cellular metabolism, causing disturbances in acid-base balance and nervous system function, and posing life-threatening conditions. The most important pathogenic mechanism causing carbon dioxide retention in these diseases is still inadequate alveolar ventilation.
Can people with respiratory failure exercise?
Whether people with respiratory failure can exercise depends mainly on whether the respiratory failure occurred acutely or chronically. Generally, it is usually advised against exercising during acute respiratory failure, such as severe pulmonary inflammation, drowning, or failure of the nervous system functions. Exercise during this time can worsen the body's oxygen deficit and increase oxygen consumption, potentially exacerbating the symptoms of the disease. However, for chronic respiratory failure, such as chronic obstructive pulmonary disease (COPD) or chronic pulmonary interstitial fibrosis, patients have long been enduring hypoxia or hypercapnia. These individuals can engage in appropriate respiratory rehabilitation exercises, such as respiratory rehabilitation gymnastics and some traditional Chinese medicine practices, which can greatly aid in the recovery from the disease, particularly respiratory failure. The decision primarily depends on the patient’s specific condition and their physical tolerance.
Causes of Respiratory Failure
Respiratory failure is relatively common in clinical practice and is frequently seen in critical respiratory conditions. The causes of respiratory failure most often arise from diseases of the respiratory and circulatory systems, such as chronic obstructive pulmonary disease, acute exacerbation of asthma, severe pneumonia, severe pulmonary tuberculosis, diffuse pulmonary fibrosis, pulmonary edema, pneumoconiosis, pulmonary embolism, various causes of heart failure, pulmonary hypertension, severe pneumothorax, and substantial pleural effusion, among others. These can all lead to respiratory failure. Therefore, if respiratory distress occurs clinically and respiratory failure is suspected, it is crucial to conduct prompt examinations and actively manage the condition.
Treatment principles for respiratory failure
Respiratory failure is a common emergency condition in the respiratory system, with patients often experiencing significant breathing difficulties, cyanosis, etc. So, what are the principles of treatment for respiratory failure? The overall principles of treatment are to enhance respiratory support, including maintaining airway patency, correcting hypoxia through oxygen therapy, and improving ventilation with the use of ventilators, among other measures. Additionally, it is important to intensify treatment of the causes and inducers of respiratory failure, such as controlling infections. Attention should also be paid to general supportive treatment, such as nutritional support, correcting electrolyte imbalances, etc., as well as protecting other vital organs, like the liver and kidneys.
What are the symptoms of respiratory failure?
Respiratory failure is a common critical illness in clinical settings, characterized by serious impairments in the lung's ventilation and gas exchange functions. What are the symptoms after respiratory failure? First and foremost, the earliest and most obvious symptom is difficulty breathing. Many patients experience significant difficulty breathing; severe cases may even involve orthopnea, profuse sweating, and inability to speak. Another important symptom is cyanosis, which is a typical manifestation of hypoxia. Additionally, there can be neuropsychiatric symptoms such as mental confusion, agitation, convulsions, and even coma. Other systems may also exhibit symptoms, such as tachycardia, arrhythmias, and decreased gastrointestinal function.
Causes of respiratory failure
Respiratory failure is a severe breathing difficulty that can lead to hypoxia and carbon dioxide retention. The causes of respiratory failure can be broadly classified into the following categories: First, there are diseases of the lung parenchyma, such as various lung infections, pneumonia, pulmonary edema, lung abscess, and diseases of the lung interstitium. Another type involves obstruction of the airway, including obstruction in the upper respiratory tract, which covers the nose, pharynx, and larynx, as well as obstructions in the lower respiratory tract, which can also lead to respiratory failure. Third, there are diseases involving the peripheral nervous transmission system and the respiratory machinery, such as acute infectious polyradiculoneuritis, poliomyelitis, and some cervical spine injuries. These can severely affect the respiratory center and respiratory nerves, leading to respiratory failure.
How to grade respiratory failure
Respiratory failure is generally not graded; instead, it is classified into types. There are two types, Type I and Type II. Type I is characterized by an oxygen tension lower than 60 mmHg, at which point, there is no increase in carbon dioxide, and the carbon dioxide level is normal. Type II respiratory failure is when the oxygen tension is below 60 mmHg, accompanied by an increase in carbon dioxide, which is then termed Type II respiratory failure. Regarding respiratory failure, it is classified by type and not by severity grade. This means that once it meets these criteria, it is referred to as respiratory failure, and at this point, some emergency treatments to improve low oxygen levels are necessary. Therefore, respiratory failure is generally not graded into mild, moderate, or severe degrees. It is only differentiated into different types. Of course, there are different severity levels in respiratory failure, but we generally do not apply a specific degree of severity.
Treatment of Respiratory Failure
Respiratory failure refers to the severe impairment of lung ventilation and gas exchange function caused by various reasons. The treatment of respiratory failure is comprehensive. Firstly, it is necessary to maintain the patency of the airway. Second, oxygen therapy is required. Oxygen therapy is mainly used to correct the patient's hypoxia. Third, a ventilator can be used to assist breathing. Fourth, the cause of the condition should be addressed. For example, if it is caused by a severe infection, aggressive anti-infection measures should be taken; if caused by a large amount of pleural effusion, aggressive drainage of the pleural fluid should be undertaken, etc. Additionally, general supportive therapy should be considered, such as maintaining electrolyte and acid-base balance. It is also important to protect the function of vital organs, such as maintaining the function of the heart and lungs, etc.