Causes of CO2 retention in respiratory failure

Written by Wang Ji Zhong
Internal Medicine
Updated on December 25, 2024
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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 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.

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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 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 Han Shun Li
Pulmonology
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Causes of Respiratory Failure

Respiratory failure is relatively common in clinical practice and is frequently seen in critical respiratory conditions. The causes of respiratory failure most often arise from diseases of the respiratory and circulatory systems, such as chronic obstructive pulmonary disease, acute exacerbation of asthma, severe pneumonia, severe pulmonary tuberculosis, diffuse pulmonary fibrosis, pulmonary edema, pneumoconiosis, pulmonary embolism, various causes of heart failure, pulmonary hypertension, severe pneumothorax, and substantial pleural effusion, among others. These can all lead to respiratory failure. Therefore, if respiratory distress occurs clinically and respiratory failure is suspected, it is crucial to conduct prompt examinations and actively manage the condition.

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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.