How to administer oxygen for respiratory failure.

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 28, 2024
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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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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.

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Written by Han Shun Li
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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.

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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.

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Written by Wang Xiang Yu
Pulmonology
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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.

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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.