Causes of respiratory failure

Written by Wang Ji Zhong
Internal Medicine
Updated on November 20, 2024
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Respiratory failure is a severe breathing difficulty that can lead to hypoxia and carbon dioxide retention. The causes of respiratory failure can be broadly classified into the following categories: First, there are diseases of the lung parenchyma, such as various lung infections, pneumonia, pulmonary edema, lung abscess, and diseases of the lung interstitium. Another type involves obstruction of the airway, including obstruction in the upper respiratory tract, which covers the nose, pharynx, and larynx, as well as obstructions in the lower respiratory tract, which can also lead to respiratory failure. Third, there are diseases involving the peripheral nervous transmission system and the respiratory machinery, such as acute infectious polyradiculoneuritis, poliomyelitis, and some cervical spine injuries. These can severely affect the respiratory center and respiratory nerves, leading to respiratory failure.

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Internal Medicine
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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 Peng Miao Yun
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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 Li Fang Xiao
Internal Medicine
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Is respiratory failure uncomfortable?

Respiratory failure is quite uncomfortable, and clinically, the symptoms feel severe, and the patient's own state is also very affected. Respiratory failure is mainly caused by a decrease in oxygen partial pressure, during which time the patient may experience wheezing, chest tightness, and even a feeling of being near death. There are many causes of respiratory failure, with severe infections being common, such as severe pneumonia or sepsis. A systemic inflammatory response can lead to respiratory failure. Another situation is when heart failure occurs, which can also accompany pulmonary congestion, causing pulmonary ventilation dysfunction that can also lead to respiratory failure. The treatment of respiratory failure focuses on removing the causative factors and selectively choosing different treatment plans, which can start with oxygen therapy or the use of a ventilator in severe cases to correct hypoxemia and sustain life.

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Written by Wang Ji Zhong
Internal Medicine
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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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Can respiratory failure be cured?

Respiratory failure can potentially be cured, and the key lies in identifying the cause of the respiratory failure. For instance, acute inflammatory infections, such as severe pneumonia and other infectious diseases, can lead to dysfunction in lung ventilation and gas exchange, manifesting as respiratory failure. With the aggressive use of antibiotics and anti-infection drugs, once the infection is controlled, respiratory failure can also be corrected accordingly. Furthermore, if it is a complication of other diseases, such as acute left heart failure, respiratory failure can also occur. This type of respiratory failure will quickly improve once heart function is corrected. However, in the case of chronic diseases such as chronic obstructive pulmonary disease, bronchiectasis, asthma, and other causes, respiratory failure can only be managed with medication to alleviate symptoms, and it cannot be completely cured.