Respiratory failure is a condition that can arise with a rapid onset, such as acute respiratory failure, or over the course of several months or even years. It is characterized by a failure in the function of the respiratory system.

What is respiratory failure?

Respiratory failure is a condition in which the respiratory system is not able to adequately oxygenate the blood, which leads to compromise the supply of oxygen to the various organs and tissues, which ultimately affects their functioning.

In order to make this diagnosis, it is necessary to determine the levels of partial pressure of oxygen (PaO 2 ) and carbon dioxide (PaCO2) in an arterial blood sample.

To speak of respiratory failure, the PaO2 must be less than 60 mmHg, the PaCO2 greater than 50 mmHg, or both conditions.

Severe respiratory insufficiency

It is a serious condition that can be life-threatening, which is why its management is intrahospital, meriting in many cases its treatment in an intensive care unit.

It is characterized by the evolution of respiratory failure in a short period of time. This is manifested by symptoms such as shortness of breath, increased respiratory rate, breath sounds, bluish discoloration of the skin and mucous membranes, tiredness, weakness and altered state of consciousness that can range from confusion to coma.

Causes of acute respiratory failure

In this situation, respiratory failure sets in quickly within minutes to a few days. It is usually related to the presence of serious conditions, including:

  • Central nervous system disorders that affect respiratory function. This includes strokes, head injuries or tumor lesions that involve the respiratory centers located in the brain stem.
  • Injuries to the peripheral nerves that regulate the functioning of the respiratory muscles (Guillain Barre syndrome).
  • Muscle diseases that cause weakness or paralysis (such as myasthenia gravis).
  • Disorders that compromise the mobility of the chest and therefore hinder its expansion.
  • Severe respiratory infections
  • Acute cardiac disorders such as heart attacks with pulmonary repercussion or cardiac arrest.
  • Obstructive diseases such as bronchial asthma, COPD (chronic obstructive pulmonary disease) or the presence of foreign bodies or tumors that obstruct the airway.
  • Compromise of pulmonary blood circulation. Mainly due to obstruction of the pulmonary artery or pulmonary embolism thrombus.
  • Overdose of drugs that have a depressant effect on the respiratory or central nervous system, mainly opioid analgesics.

Chronic respiratory failure

In this type of respiratory failure, oxygenation is slowly and progressively compromised, so the body manages to make changes that allow it to adapt to this condition.

These changes include an increase in respiratory rate that seeks to improve ventilation and an increase in the production of a hormone called erythropoietin, which stimulates the production of red blood cells at the bone marrow level, thereby increasing the ability to transport oxygen. in the blood.

In general, a person with a condition that leads to the development of chronic respiratory insufficiency can maintain relatively normal levels of O 2 and CO 2 in the blood while at rest, altering this only in the case of carrying out some type of physical activity or in the course of any condition that impairs respiratory function, such as a bronchopulmonary infection, a cardiovascular event or the use of medications that affect respiratory function.

In cases of basic diseases in an advanced stage, respiratory failure manifests itself even during rest.

You may be interested in reading about shortness of breath .

What is the treatment of respiratory failure

Treatments can be classified according to different conditions, whether they are acute or chronic conditions.

Treatment of acute respiratory failure

This condition requires management with strict supervision of the patient, which is why it is carried out in intensive care units.

Patients merit lying in a semi-sitting position with an oxygen supply, which can be done with a mask or with a mechanical ventilator, depending on the severity of the condition.

When the spulmonary origin, bronchodilator drugs are used by inhalation, and can be supplemented with drugs with an effect on the respiratory system, including steroids, intravenously.

In these patients, measures must also be adopted to prevent them from developing an in- hospital respiratory infection, as well as the complications of staying in bed, such as venous thrombosis.

Treatment of chronic respiratory failure

People affected by this condition merit the intermittent use of oxygen.

Also important is the treatment of the underlying condition that led to respiratory failure, as well as the complications that accompany chronic respiratory failure, mainly respiratory infections.

These patients also benefit from a respiratory physiotherapy program.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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