Respiratory Failure

Respiratory Failure

In the case of respiratory insufficiency, there is reduced ventilation of the pulmonary alveoli due to a disruption in external respiration. Those affected suffer from shortness of breath, coughing and poor performance.

What is respiratory failure?

Respiratory failure is also known as respiratory failure. The gas exchange in the lungs is disturbed. This leads to pathologically altered blood gas values. A distinction can be made between acute and chronic insufficiency. The symptoms of acute insufficiency are similar to those of chronic insufficiency. However, they start much more suddenly and are therefore often accompanied by a severe panic reaction. For what does lbd stand for, please visit biotionary.com.

In addition, the insufficiencies can be divided into partial and global insufficiencies according to their extent. Respiratory failure is not a disease in its own right, but rather a complex of symptoms caused by various other diseases. The insufficiency is therefore always treated by treating the underlying disease. However, oxygen supplements can improve symptoms.

Causes

Respiratory insufficiency is caused by obstructive and restrictive ventilation disorders of the lungs. In the case of restrictive ventilation disorders, the lungs are no longer sufficiently flexible, and this can also apply to the chest. This leads to reduced lung volume. In particular, the vital capacity, the functional residual capacity and the residual volume are restricted. Restrictive ventilation disorders can occur with deformities of the chest.

The most common causes of such chest deformities are trauma or scoliosis. Reduced ventilation of the air sacs in the lungs in the case of pneumonia can also lead to a restrictive ventilation disorder. Adhesions in the chest (e.g. pleural plaques), pulmonary edema or neuromuscular diseases can also reduce the elasticity of the lungs and chest.

In the case of an obstructive ventilation disorder, the flow resistance in the airways is increased. As a result, the airway resistance, the functional residual capacity and the residual volume are increased. The air sacs in the lungs are not evenly ventilated, so the lungs overinflate in the long term. Furthermore, the entire lung and bronchial system is mechanically damaged.

In the long term, this reduces the vital capacity of the lungs. Among other things, an obstructive ventilation disorder is accompanied by bronchial asthma, cystic fibrosis, pulmonary emphysema or chronic obstructive pulmonary disease (COPD). Acute respiratory failure is usually caused by pneumonia, aspiration of water or foreign bodies, or injuries to the lungs and chest.

A disturbance of the respiratory center in the brain can also lead to acute respiratory failure. Chronic respiratory failure is more likely to be caused by chronic lung disease or cancer. Respiratory insufficiency can also develop after the surgical removal of a lung (pneumonectomy) or a lung lobe (lobectomy).

Symptoms, Ailments & Signs

In the case of partial insufficiency, the oxygen partial pressure in the arterial blood system drops. However, the carbon dioxide partial pressure can still be compensated so that only hypoxemia but no hypercapnia occurs. In global respiratory failure, hypoxemia is accompanied by hypercapnia. This means that the oxygen content in the blood is reduced, while the partial pressure of carbon dioxide is increased.

In acute respiratory failure, symptoms appear suddenly. Those affected suffer from attacks of shortness of breath with a feeling of suffocation. The acute asthma attack with coughing and difficult breathing is also a temporary respiratory insufficiency. If the respiratory center is damaged, however, there is no shortness of breath. Instead, those affected become unconscious immediately and die quite quickly without treatment.

Chronic respiratory failure is far more common than the acute form. Shortness of breath and coughing also occur here. Due to the chronic lack of oxygen, the patients are no longer as efficient. A blue discoloration of the skin (cyanosis) may be observed. Symptoms such as drumbeater fingers or watch glass nails can occur in longer courses.

Diagnosis & course of disease

At the beginning of the diagnosis, the patient is thoroughly examined. Auscultation and percussion of the lungs are performed. Weakened breathing sounds, background noises or rattling noises may be heard here. Air-filled or dead breathing spaces can be discovered on percussion.

Imaging procedures such as chest X-ray or computed tomography provide further clarity. Magnetic resonance imaging or lung scintigraphy can also be performed. With the help of an endoscope, the bronchi (bronchoscopy) and the mediastinal space (mediastinoscopy) can be imaged.

With the methods of lung function diagnostics, the performance of the lungs can be determined. Spirometry and body plethysmography are important methods of lung function diagnostics. Partial insufficiency in the blood gas analysis in the laboratory shows an oxygen partial pressure below 75 mmHg. In global insufficiency, the carbon dioxide partial pressure is also over 45 mmHg. The blood gas analysis is carried out from the capillary blood after removal from the earlobe.

Complications

Respiratory failure is a serious complication of lung or heart disease. It leads to an undersupply of oxygen to the body and especially to the brain. As a result, serious and often life-threatening complications occur. The severe shortness of breath can lead to impaired consciousness and even coma. Initially, the disturbances of consciousness become noticeable in states of confusion.

There can also be a sharp drop in blood pressure. The heart rate is often very low. In addition, a gross shaking of the hands (flapping tremor) is often observed. These complications can only be prevented by artificial respiration. Chronic respiratory failure cannot be cured because it is caused by incurable lung diseases such as pulmonary emphysema, COPD or pulmonary fibrosis.

In the chronic form of the disease, long-term therapy with oxygen ventilation must therefore be carried out. Otherwise, there will be permanent impairment of brain and heart function, which can lead to long-term damage or even death. Depending on the cause, the course of acute respiratory failure can be moderate or very severe.

Possible causes for severe acute forms include sepsis, severe heart disease, pneumonia or acute pancreatitis. Mechanical ventilation is required to prevent severe disturbances of consciousness, including coma, cardiac arrhythmias and sudden cardiac death. Otherwise, the underlying diseases play a major role in the prognosis.

When should you go to the doctor?

As a rule, this disease should always be treated by a doctor. In the worst case, the patient may die if the disease is not treated in time. The earlier it is detected, the higher the chance of a complete cure. A doctor is to cut open if the person concerned suffers from severe breathing difficulties. A cough develops, and the patients also appear very tired. The air you breathe can also taste like carbon.

The person affected can also lose consciousness completely as a result of the symptoms. If the skin turns blue or the person concerned becomes unconscious, call an ambulance or go to the hospital immediately. First aid should be given before the emergency doctor arrives. The condition is usually treated by an internist. A complete cure cannot be guaranteed.

Treatment & Therapy

Respiratory failure can only be treated by treating the underlying disease. Oxygen may be given to help affected patients breathe. The patient may need permanent artificial ventilation.

Prevention

Not all lung diseases that can cause respiratory failure can be prevented. However, there are avoidable factors that can promote the development of lung disease. Avoiding these harmful factors can protect against pulmonary diseases. The main risk factor for lung disease is smoking.

Cigarette smoke contains more than 90 harmful substances. These not only weaken the immune system, they also reduce the ability of the lung tissue to clean itself. Another risk factor for lung diseases is indoor radon. Radon is a radioactive noble gas that occurs naturally in soil and rocks.

Radon can enter living spaces through leaks in the floor area of ​​the house. Poorly insulated old buildings and houses without a base plate are particularly at risk. If the radon levels in the house are high, the insulation should be renewed.

Aftercare

After the successful therapy of respiratory failure, it is of fundamental importance to continue the treatment in order to prevent the disease from breaking out again. Breathing aids that ensure oxygen uptake and supply should therefore continue to be used even if the symptoms subside. However, the supply of oxygen should always be adapted to the oxygen content in the blood. For this purpose, this must be measured regularly by the doctor.

If another disease triggered respiratory failure, it must be treated further even after the respiratory failure has resolved. Depending on the underlying disease, it may be necessary to take certain medications for life. The follow-up treatment should be specifically tailored to the underlying disease and discussed with the doctor.

If a lung tumor was the cause of the respiratory insufficiency, regular lung function tests by the responsible specialist and checks of the oxygen levels in the blood are necessary even after its treatment. In addition, the development of respiratory insufficiency should be a warning signal, especially for smokers.

For follow-up treatment, it is absolutely necessary to refrain from smoking under all circumstances, as this permanently worsens the lung function and the oxygen uptake in the blood, but also the blood circulation. In addition, sport and exercise can improve lung function and blood circulation and are highly recommended for follow-up treatment, as is weight loss in overweight patients.

You can do that yourself

Regardless of the cause of respiratory failure, patients should strictly follow the doctor’s recommendations. This means that the medication is taken according to plan. If the condition of the breathing problems worsens, the next doctor’s appointment is due. A flu vaccination can protect those affected from additional symptoms.

It also makes sense to take certain safety precautions for everyday situations in the car and when travelling. This way, you won’t have a panic attack, even on longer journeys. Smokers who suffer from respiratory failure should definitely stop smoking because nicotine makes the symptoms worse. If you have constant headaches due to shortness of breath or your ability to concentrate decreases, it makes sense to assess your own symptoms correctly and to clarify them at your next doctor’s appointment. Often the respiratory failure is related to another disease. That is why it can only be treated successfully together with the cause.

Taking the prescribed medicines correctly will reduce the symptoms. In the event of an acute attack, a light breathing exercise may help to combat the rising panic. If this does not work, artificial respiration must be given as soon as possible. For longer-lasting, chronic breathing difficulties, transportable liquid oxygen systems are available, which patients should always have with them.

Respiratory Failure