What is acute respiratory failure?

Written by Li Tao
Pulmonology
Updated on September 16, 2024
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Respiratory failure refers to the severe dysfunction in pulmonary ventilation and gas exchange in the respiratory system caused by various reasons under normal conditions. This dysfunction leads to ineffective gas exchange during respiration, resulting in hypoxia in the body and retention of carbon dioxide, thereby causing a series of physiological and metabolic disorders. Typically, under resting conditions at sea-level atmospheric pressure, respiratory failure is defined when arterial oxygen tension falls below 60 mmHg, accompanied by carbon dioxide retention, with carbon dioxide tension exceeding 50 mmHg, or without an increase in carbon dioxide tension. It is categorized into acute respiratory failure and chronic respiratory failure.

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Written by Li Tao
Pulmonology
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What is acute respiratory failure?

Respiratory failure refers to the severe dysfunction in pulmonary ventilation and gas exchange in the respiratory system caused by various reasons under normal conditions. This dysfunction leads to ineffective gas exchange during respiration, resulting in hypoxia in the body and retention of carbon dioxide, thereby causing a series of physiological and metabolic disorders. Typically, under resting conditions at sea-level atmospheric pressure, respiratory failure is defined when arterial oxygen tension falls below 60 mmHg, accompanied by carbon dioxide retention, with carbon dioxide tension exceeding 50 mmHg, or without an increase in carbon dioxide tension. It is categorized into acute respiratory failure and chronic respiratory failure.

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Written by Peng Miao Yun
Internal Medicine
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Care of Patients with Respiratory Failure

In the nursing care of patients with respiratory failure, it is important to strictly monitor vital signs daily, as respiratory failure is considered an emergency and critical condition clinically. Observe the patient's blood pressure, consciousness state, and respiratory rate. At the same time, good skin care and oral care should be maintained to prevent aspiration pneumonia and bedsores. Most importantly, secretions should be cleared in a timely manner, including phlegm. Conscious patients should be encouraged to cough forcefully. For patients who are weak in coughing, assist them in turning and patting their backs regularly to facilitate the expulsion of phlegm. For comatose patients, mechanical suction can be used to maintain airway patency. It is advisable to avoid factors that may cause breathing difficulties, such as cold wind and poor air circulation. Pay attention to enhancing physical exercise appropriately, preventing colds, and maintaining a regular lifestyle.

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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 An Yong Peng
Pulmonology
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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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Classification of Causes of Respiratory Failure

Respiratory failure, if categorized by its cause, can be divided into pump failure and lung failure. Pump failure refers to the failure of the respiratory pump, which comprises the central nervous system that drives or regulates respiratory movement, the peripheral nervous system, neuromuscular tissues, and the thoracic cage, collectively known as the respiratory pump. Respiratory failure caused by dysfunction of these components is called pump failure. Another type is lung failure, which results from airway obstruction, pulmonary tissue and vascular pathology, and is termed lung failure. Lung failure can lead to type I or type II respiratory failure, whereas pump failure typically presents as type II respiratory failure.