Respiratory failure

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What is it about ?

Breathing is used to supply oxygen to the blood and to remove wastes such as carbon dioxide (CO2). This mechanism is provided by the respiratory tract and the alveoli. The airways are a system of branching tubes that allow the air we breathe to be transported from the atmosphere to the alveoli. In the alveoli, oxygen is then released to the blood, and carbon dioxide is removed from the blood.

In respiratory failure, the exchange of oxygen and carbon dioxide between the blood and the environment is disturbed and no longer takes place normally. Respiratory failure can occur suddenly (acute) or gradually (chronic).

Acute respiratory failure

Acute respiratory failure can be caused by a disorder in any of the stages responsible for breathing:

  • suppression of the respiratory center in the brain by a disease of the central nervous system, loss of consciousness, an overdose of drugs or illegal drugs …
  • stopping the transmission of nerve impulses from the brain to the respiratory muscles due to spinal cord injury, muscle disease, infection of the nervous system, etc.
  • reduced mobility of the thorax following a crush injury, pneumothorax …
  • obstruction of the airways by a foreign body, a tumor, a severe asthma attack or chronic obstructive pulmonary disease (COPD) …
  • disease of the pulmonary alveoli such as pneumonia, pulmonary edema, etc.
  • insufficient blood supply to the lungs due to pulmonary embolism …
  • lack of oxygen in the blood due to anemia, carbon monoxide poisoning …
  • prolonged convulsions

Chronic respiratory failure

Chronic respiratory failure, like acute respiratory failure, can be caused by a disorder of the airways or alveoli. The cause may be a prolonged or permanent disruption of the functions of the respiratory center in the brain, the nerves responsible for respiration, the respiratory muscles, the chest or the lungs themselves. The most common diseases leading to chronic respiratory failure are:

How to recognize it?

The main feature of respiratory failure is shortness of breath.

In acute respiratory failure, you feel like you cannot breathe well. This is accompanied by restlessness, confusion, and sometimes a drop in consciousness. The accessory respiratory muscles are then activated. You are short of breath, the muscles between the ribs and above the breastbone contract, and your breathing quickens.

With chronic respiratory failure, you are often tired during the day, and you have memory problems or difficulty concentrating. Your lips, fingers and toes may turn blue (cyanosis). Since symptoms worsen especially at night, you are often restless in your sleep, and during the day you fall asleep and have a headache. Chronic lung disease makes you more susceptible to acute attacks.

How is the diagnosis made?

The doctor will first ask you questions about your breathing, sleep, fatigue, memory and concentration. Then he will listen to your lungs, paying attention to abnormal noises such as hissing (wheezing) or crackling (crackling). He will check if you are using the accessory respiratory muscles and if your skin, lips and nails are blue; he will also examine your legs and neck for a Water retention (sign that the heart is overloaded).

The doctor will place a pulse oximeter on your finger to measure the amount of oxygen in the blood. He will monitor your breathing rate (respiratory rate) and also perform lung function tests (spirometry) to measure your lung capacity.

In hospital, acidity (pH), oxygen pressure (pO2) and CO2 can be checked on a blood sample from a small artery. Based on these values, the doctor can determine what type of respiratory failure you have.

What can you do ?

No smoking (including passive smoking). Get help to quit smoking. The doctor can assist you in this process. Get enough exercise, even if it takes effort. Even small steps improve fitness and lung capacity, and maintain muscle function. The physiotherapist can teach you breathing exercises. Do them several times a day at home. There are also small devices to train you in and out and improve your breathing.

What can the doctor do?

There should always be enough oxygen in your blood, and the lungs need to be well ventilated. Therefore, administering oxygen in the right dose can certainly help. If you give too much oxygen, you will breathe less deeply, making your condition even worse. There are not many drugs that can be used in this case. However, a small dose of cortisone can improve breathing, and diuretics and heart medication are sometimes used.

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Source
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