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 Wei Shi Liang

Intensive Care Unit

1min 5sec

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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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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.

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Written by Wang Ji Zhong

Internal Medicine

46sec

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Causes of CO2 retention in respiratory failure

Respiratory failure manifests as hypoxia and the retention of carbon dioxide. The main cause of carbon dioxide retention is pathological changes in the respiratory system, such as chronic obstructive pulmonary disease with respiratory failure, status asthmaticus, pulmonary heart disease, lung cancer, etc. Some neuropathies that cause paralysis of the respiratory muscles can lead to respiratory dysfunction, resulting in the retention of carbon dioxide in the body, affecting normal cellular metabolism, causing disturbances in acid-base balance and nervous system function, and posing life-threatening conditions. The most important pathogenic mechanism causing carbon dioxide retention in these diseases is still inadequate alveolar ventilation.

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Written by Li Fang Xiao

Internal Medicine

1min 1sec

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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.

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Written by Wang Li Bing

Intensive Care Medicine Department

38sec

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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.