How to administer oxygen for respiratory failure

Written by Peng Miao Yun
Internal Medicine
Updated on September 27, 2024
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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.

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Written by Han Shun Li
Pulmonology
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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.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Han Shun Li
Pulmonology
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What are the symptoms of respiratory failure?

Respiratory failure is a common and serious condition in clinical settings, often categorized as an acute and critical illness. Simply put, respiratory failure occurs when respiratory function is extremely poor. It is caused by severe impairment of pulmonary ventilation and gas exchange due to various reasons. Even at rest, sufficient gas exchange cannot be maintained, leading to serious hypoxemia or concurrent hypercapnia. Clinically, this often presents with severe breathing difficulties, hypoxia, cyanosis, and requires immediate intervention to prevent potentially life-threatening complications.

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Written by Wei Shi Liang
Intensive Care Unit
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The earliest clinical symptoms of respiratory failure

The clinical symptoms of respiratory failure mainly manifest as hypoxemia and carbon dioxide retention. Looking at their clinical manifestations, mild hypoxia may not show any clinical symptoms. As the severity of the disease increases, there can be signs of increased respiratory drive, such as rapid breathing or difficulty breathing, along with symptoms of sympathetic nervous system activation, such as anxiety and sweating. Hypoxemia can cause dilation of peripheral arteries and constriction of veins, leading to an increased heart rate, or even severe arrhythmias. Furthermore, considering the clinical manifestations of carbon dioxide retention, they are directly related to the levels of carbon dioxide in the body, mainly depending on the rate of occurrence. Clinically, this primarily affects myocardial contractility, the contractile ability of respiratory muscles, and increases in intracranial blood flow. In mild to moderate cases, it can stimulate the respiratory center causing increased and shallow breathing, but in severe cases, it may suppress the respiratory center.

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Written by Peng Miao Yun
Internal Medicine
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Can respiratory failure be cured?

Respiratory failure is a critical condition in clinical settings, characterized by high mortality rates and the potential to impair multiple organ functions, thus endangering the lives of patients. However, in cases of chronic respiratory failure, it is generally incurable, as the respiratory function of these patients has already declined significantly. For patients with acute respiratory failure, the possibility of recovery is closely tied to the ability to diagnose early and administer effective treatment promptly. If acute respiratory failure is treated effectively early on by removing the trigger and the cause, and if the respiratory function can significantly improve within a short time, then there is still a chance for a cure.