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Respiratory failure
Is respiratory failure contagious?
First, it's important to understand what respiratory failure is. Respiratory failure is a syndrome, not a disease, meaning it can result from many causes. For instance, airway obstruction, lung tissue pathology, diseases of the pulmonary vessels, and diseases of the thorax and pleura, as well as neuromuscular diseases, can all lead to impaired ventilation or gas exchange in the lungs. This impairment makes it impossible for the body to maintain adequate gas exchange even in a resting state, resulting in hypoxemia, with or without hypercapnia, which is referred to as respiratory failure. Therefore, there are many causes of respiratory failure, and some diseases are indeed contagious, such as SARS, H1N1, and H3N2. However, other causes, such as tumors or pulmonary embolism, are generally not contagious.
Principles of oxygen therapy for respiratory failure
Patients with respiratory failure undergoing oxygen therapy should be treated differently depending on the type of respiratory failure. If it is Type I respiratory failure, it is simply hypoxia without accompanying carbon dioxide retention. Our oxygenation principle can provide slightly higher oxygen flow, with an oxygen flow rate exceeding 5 liters per minute. However, if it is Type II respiratory failure, which comes with severe carbon dioxide retention, it requires continuous low-flow oxygenation. This type of respiratory failure is often caused by chronic pulmonary diseases. Because if high-flow oxygen is provided, the peripheral chemoreceptors' response to hypoxia will decrease in the short term, which will exacerbate respiratory suppression, leading to increased carbon dioxide retention and worsening the condition. Therefore, for Type II respiratory failure, low-flow continuous oxygen should be provided, with an oxygen flow rate controlled below 3 liters per minute.
Can respiratory failure be cured?
Whether respiratory failure can be cured depends on the causes of the respiratory failure and the severity of the condition. Respiratory failure can potentially be cured. For example, acute left heart failure can lead to pulmonary congestion and subsequent respiratory failure. This condition primarily manifests as a decrease in oxygen tension, and by conducting a blood gas analysis, if the oxygen tension is found to be less than 60 mmHg, it can be diagnosed as respiratory failure. However, with symptomatic treatments such as vasodilation and diuretics, once the left heart failure is alleviated, the respiratory failure will also improve. On the other hand, for diseases intrinsic to the lungs, such as chronic obstructive pulmonary disease or severe pulmonary infections, these chronic conditions cannot be completely cured. The symptoms of respiratory failure can only be managed with medication or ventilators.
What are the symptoms of respiratory failure?
Respiratory failure is a common critical condition in clinical settings. At the stage of respiratory failure, patients often experience severe discomfort and pain. Common symptoms include difficulty breathing, with many patients showing obvious respiratory distress, often needing to sit upright to breathe, profuse sweating, and an inability to continue normal activity. Additionally, cyanosis can occur, indicating very severe hypoxia. Symptoms of pulmonary encephalopathy, such as mental confusion, convulsions, and agitation, may also appear. In severe cases, patients may even fall into a coma. Hence, at the stage of respiratory failure, patients suffer considerably.
How to administer oxygen for respiratory failure.
First, we should evaluate whether the patient has type I or type II respiratory failure based on arterial blood gas analysis. Type I respiratory failure is primarily characterized by low oxygen tension, indicating a state of hypoxia, with normal carbon dioxide tension, in which case high-flow oxygen therapy can be administered. In type II respiratory failure, both the oxygen tension is low and the carbon dioxide tension is high. In this case, only low-flow oxygen therapy should be given, or non-invasive ventilation, or endotracheal intubation connected to mechanical ventilation may be employed.
How to administer oxygen for respiratory failure
If patients with respiratory failure undergo oxygen therapy, it is necessary to choose different therapy plans based on the type of respiratory failure. In the case of Type I respiratory failure, there is simply a lack of oxygen. For Type II respiratory failure, there is not only a lack of oxygen but also an accumulation of carbon dioxide. Therefore, for Type I respiratory failure, the oxygen flow can be higher, over five liters per minute, and the patient can continuously receive oxygen without causing significant side effects. However, for Type II respiratory failure, it is essential to control the oxygen flow at a low rate, under three liters per minute, otherwise, it may lead to other complications.
Respiratory failure classified by etiology
Respiratory failure can be classified according to its causes into four types. The first type involves diseases of the airway such as bronchial inflammation, bronchiectasis, and foreign body obstruction, leading to insufficient ventilation. The second type is due to lung tissue diseases, such as pneumonia, severe tuberculosis, emphysema, diffuse pulmonary fibrosis, adult respiratory distress syndrome, etc., causing a state of hypoxia and carbon dioxide retention due to ventilatory defects. The third type includes pulmonary vascular diseases, such as pulmonary vascular embolism and pulmonary infarction, which cause part of the venous blood to flow into the pulmonary veins, resulting in hypoxia. The fourth type involves diseases of the thoracic cage such as chest trauma, surgical trauma, pneumothorax, and pleural effusion, which affect daily activities and lung expansion, leading to insufficient lung ventilation and resulting in respiratory failure.
Is respiratory failure serious?
Respiratory failure is a common and critical condition in the respiratory system, and it is very serious. Respiratory failure manifests as a severe decline in respiratory function, often with significant damage to the lungs' ventilation and gas exchange capabilities. Patients often experience severe chest tightness, difficulty breathing, obvious hypoxic cyanosis, and may even present with symptoms such as convulsions and coma, which can be fatal. Treatment usually requires oxygen therapy and often the assistance of a ventilator. Therefore, respiratory failure is considered a very serious condition clinically and requires proactive management to save the patient's life.
Is respiratory failure serious?
Respiratory failure is a relatively severe disease, with the most common causes being chronic obstructive pulmonary disease (COPD) or heart failure, which are frequently seen in clinical settings. Respiratory failure can be definitively diagnosed by performing blood gas analysis. Clinically, patients will exhibit symptoms of breathing difficulty, such as orthopnea or wheezing. In blood gas analysis, oxygen saturation is often below 90%, and the partial pressure of oxygen is less than 60 mmHg. These indicators can diagnose respiratory failure. Although respiratory failure is a serious condition, it can be recoverable through active symptomatic treatment, identifying the underlying cause, and eliminating aggravating factors.
What is acute respiratory failure?
Respiratory failure refers to the severe dysfunction in pulmonary ventilation and gas exchange in the respiratory system caused by various reasons under normal conditions. This dysfunction leads to ineffective gas exchange during respiration, resulting in hypoxia in the body and retention of carbon dioxide, thereby causing a series of physiological and metabolic disorders. Typically, under resting conditions at sea-level atmospheric pressure, respiratory failure is defined when arterial oxygen tension falls below 60 mmHg, accompanied by carbon dioxide retention, with carbon dioxide tension exceeding 50 mmHg, or without an increase in carbon dioxide tension. It is categorized into acute respiratory failure and chronic respiratory failure.