Respiratory failure classified by etiology

Written by Peng Miao Yun
Internal Medicine
Updated on September 26, 2024
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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.

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Written by Han Shun Li
Pulmonology
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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.

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Written by Han Shun Li
Pulmonology
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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.

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Written by Han Shun Li
Pulmonology
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Clinical manifestations of respiratory failure

Respiratory failure is one of the common critical illnesses. So, what are the clinical manifestations of respiratory failure? Firstly, there is difficulty breathing, which is the most common symptom of respiratory failure. Most patients experience noticeable difficulty breathing, and in severe cases, patients may sit upright to breathe, sweat profusely, and appear very distressed. Another symptom is cyanosis, a typical sign of oxygen deficiency. Mild cases may show cyanosis at the extremities and lips, while severe cases can exhibit cyanosis throughout the body. Additional symptoms can include neurological and psychological symptoms such as confusion, mania, convulsions, coma, and drowsiness. Due to the oxygen deficiency affecting various systems, other systems may also show corresponding symptoms, such as tachycardia and arrhythmia in the circulatory system, and potential upper gastrointestinal bleeding in the digestive system.

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Written by Han Shun Li
Pulmonology
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How to rescue respiratory failure

Respiratory failure is a very serious condition clinically, and if not handled promptly, many patients may have their lives endangered. The emergency measures for respiratory failure include the following. First, it is necessary to maintain the patency of the airway. If the patient is unconscious, the patient should be placed in a supine position with the head tilted back, the lower jaw lifted, and the mouth opened to clear the airway of secretions and foreign objects. If this is insufficient, tracheal intubation and other methods should be considered to maintain airway patency. Additionally, oxygen therapy, which involves inhaling oxygen, can correct the patient's hypoxic state. If the respiratory function is very poor, consideration should also be given to using a ventilator to assist breathing. Other emergency measures include etiological treatment, supportive treatment, and protecting the function of other vital organs, among others.

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Written by Peng Miao Yun
Internal Medicine
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Care for patients with respiratory failure

Patients with respiratory failure are always emergency and critically ill patients in clinical settings. For patients with respiratory failure, we need to pay close attention in nursing: first, strictly monitor the patient's vital signs, observe the frequency of respiration, blood pressure, and consciousness state; take good care of the skin and oral cavity to prevent dependent pneumonia and bedsores; and timely remove the patient’s sputum. Encourage conscious patients to cough more and expectorate sputum. For those with weak coughs, assist regularly with turning and patting the back to facilitate the removal of sputum. For comatose patients, mechanical suction or tracheostomy for mechanical ventilation can be performed. At the same time, avoid factors that can induce respiratory difficulty such as cold air and poor air circulation. Patients with respiratory failure consume a lot of energy, especially those on mechanical ventilation, who are in a stress state with increased catabolism. Therefore, daily protein intake should be increased, encourage the patient to eat more to enhance nutrition, and provide a diet high in protein, high in fat, and low in carbohydrates.