Treatment of Respiratory Failure

Written by Han Shun Li
Pulmonology
Updated on November 07, 2024
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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 Li Qiang
Intensive Care Unit
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How to grade respiratory failure

Respiratory failure is generally not graded; instead, it is classified into types. There are two types, Type I and Type II. Type I is characterized by an oxygen tension lower than 60 mmHg, at which point, there is no increase in carbon dioxide, and the carbon dioxide level is normal. Type II respiratory failure is when the oxygen tension is below 60 mmHg, accompanied by an increase in carbon dioxide, which is then termed Type II respiratory failure. Regarding respiratory failure, it is classified by type and not by severity grade. This means that once it meets these criteria, it is referred to as respiratory failure, and at this point, some emergency treatments to improve low oxygen levels are necessary. Therefore, respiratory failure is generally not graded into mild, moderate, or severe degrees. It is only differentiated into different types. Of course, there are different severity levels in respiratory failure, but we generally do not apply a specific degree of severity.

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Written by Peng Miao Yun
Internal Medicine
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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.)

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Written by Li Fang Xiao
Internal Medicine
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Is respiratory failure serious?

Respiratory failure is a relatively severe disease, with the most common causes being chronic obstructive pulmonary disease (COPD) or heart failure, which are frequently seen in clinical settings. Respiratory failure can be definitively diagnosed by performing blood gas analysis. Clinically, patients will exhibit symptoms of breathing difficulty, such as orthopnea or wheezing. In blood gas analysis, oxygen saturation is often below 90%, and the partial pressure of oxygen is less than 60 mmHg. These indicators can diagnose respiratory failure. Although respiratory failure is a serious condition, it can be recoverable through active symptomatic treatment, identifying the underlying cause, and eliminating aggravating factors.

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Written by Li Qiang
Intensive Care Unit
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Precursors of respiratory failure

Respiratory failure can be a very acute condition, or it may evolve gradually due to chronic diseases. The basic precursors of respiratory failure generally include hypoxia or hypercapnia. In the early stages of hypoxia, patients may experience excitement or irritability, characterized by rapid breathing and possibly sweating due to the effort of breathing. Symptoms include accelerated breathing and hypoxia; the patient’s lips may also turn blue. If the level of carbon dioxide increases, once past the initial period of excitement and as the hypoxia worsens, the person may become listless. Gradually, their consciousness may become unclear, manifesting as drowsiness or possibly even coma.

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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 critical condition in clinical settings. At the stage of respiratory failure, patients often experience severe discomfort and pain. Common symptoms include difficulty breathing, with many patients showing obvious respiratory distress, often needing to sit upright to breathe, profuse sweating, and an inability to continue normal activity. Additionally, cyanosis can occur, indicating very severe hypoxia. Symptoms of pulmonary encephalopathy, such as mental confusion, convulsions, and agitation, may also appear. In severe cases, patients may even fall into a coma. Hence, at the stage of respiratory failure, patients suffer considerably.