Respiratory failure is a disease.

Written by Peng Miao Yun

Internal Medicine

Updated on September 05, 2024

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Respiratory failure is a condition caused by severe impairment of lung ventilation and gas exchange functions due to various reasons, leading to ineffective gas exchange. This results in hypoxia in the body, accompanied by either retention or non-retention of carbon dioxide, thereby causing a clinical syndrome of physiological and metabolic disorders. The causes of respiratory failure include diseases of the lung tissue, respiratory tract disorders, pulmonary vascular diseases, and cardiovascular and cerebrovascular diseases, among other factors, all of which can lead to respiratory failure.

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Written by Han Shun Li

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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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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.

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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

1min 8sec

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How to treat respiratory failure?

Treatment of patients with respiratory failure is primarily medical, focusing on suppressing or relieving the causes and triggers of respiratory failure, improving lung ventilation and gas exchange as much as possible, and treating and improving the function and condition of various vital organs. First, it is important to actively treat the primary disease causing respiratory failure. If there is a concurrent bacterial infection, sensitive antibiotics should be used, and triggers should be removed as much as possible. Simultaneously, maintaining airway patency and effective ventilation volume is necessary, which can involve administering bronchodilators and expectorants such as salbutamol, terbutaline sulfate, acetylcysteine, and ambroxol. When necessary, corticosteroids can be administered intravenously. If internal medicine treatment does not improve symptoms, tracheotomy and mechanical ventilation may be necessary to assist breathing. (Medications should be taken under the guidance of a physician, based on the actual situation.)