In human medicine, the term ventilation disorders summarizes disorders in inhalation and exhalation. A distinction is made between obstructive, restrictive and neuromuscular ventilation disorders. An increase in airway resistance is defined as obstructive, a reduction in vital capacity or total lung capacity as restrictive, and a motor limitation of breathing caused by nerves as neuromuscular.
What are ventilation disorders?
The term ventilation disorder is used in human medicine both for an obstruction in breathing due to increased breathing resistance and for reduced lung capacity – and thus also for reduced vital capacity. Increased breathing resistance can result from obstructions in the airways or external pressure on the airways. For all you need to know about skin infection, please visit phonecations.com.
Such airway resistance is referred to as obstructive. A restrictive ventilation disorder is present when lung volumes are restricted due to a change in lung function tissue. Likewise, an obstruction to breathing due to neuromuscular diseases or injuries to the chest corresponds to a restrictive ventilation disorder.
As a rule, it is a matter of reduced compliance of the respiratory system and thus also a reduced vital capacity. Both mechanical-muscular and neuromuscular problems with breathing as well as a change in the functional tissue (parenchyma) of the lungs and bronchi are equally referred to as restrictive ventilation disorders.
Neuromuscular ventilation disorders are nerve-related limitations, such as those that can occur in the case of paraplegia or a disorder of the higher-level respiratory centers in the brain.
Causes
The triggering factors of a ventilation disorder are very different. They can be differentiated between causing an obstructive, restrictive or neuromuscular disorder. For example, allergic bronchial asthma and chronic obstructive pulmonary disease ( COPD ) lead to a classic form of obstructive ventilation disorder.
Both diseases lead to a narrowing of the lumen in the bronchi due to mucosal swelling, thickening of the contracting bronchial muscles and the secretion of viscous mucus, so that the airway resistance increases. Narrowing of the airways, which are caused by space-occupying structures such as tumors, for example, are also counted among the obstructive ventilation disorders. The causes of a classic restrictive ventilation disorder include pulmonary fibrosis, paralysis (paresis) or stiffening of the diaphragm, or pleural effusion.
Lung fibrosis, which can have many different causes, is characterized by the gradual remodeling of the functional lung tissue into connective tissue-like structures with a gradual loss of function. A number of possible causative factors are also responsible for pleural effusion, an excessive accumulation of fluid between the two layers of the pleura.
Symptoms, Ailments & Signs
Signs and symptoms of a ventilation disorder cover a wide range and are largely dependent on the underlying disease or the causative factors. For example, chronic bronchitis, which can develop into COPD, is characterized by a productive cough that can last for years.
In addition, dyspnea on exertion often occurs as the disease progresses. In a severe form, resting dyspnea can also appear. A ventilatory failure caused by an acute asthma attack can cause acute shortness of breath because the airways become almost completely blocked.
Persistent urge to cough, increase in pulse rate, and marked cyanosis with blue lips can be assessed as secondary symptoms that develop due to reduced oxygenation. The remaining causes of an obstructive or restrictive ventilation disorder are usually characterized by unspecific dyspnea on exertion or at rest and by a stimulus to cough that is associated with increased mucus formation.
Diagnosis & course of disease
Ventilation disorders are always an expression of different underlying diseases, so that the determination of an obstructive, restrictive or neuromuscular ventilation disorder often does not include any statement about the causative factors. A large number of diagnostic aids are available within a pulmonary function test for the detection of a ventilation disorder, such as spirometry with measurement of vital capacity and various static and dynamic parameters.
The so-called body plethysmography or whole body plethysmography, which requires a closed cabin with specialized technology, is a little more complex. The procedure provides information about the pressure conditions in the chest and the airway resistance as well as some other parameters such as the total capacity of the lungs and the residual volume that cannot be exhaled. The course of a ventilation disorder depends on the underlying disease that caused it. In the case of COPD or pulmonary fibrosis, if left untreated, it can lead to a severe course with an unfavorable prognosis.
Complications
Depending on the cause, a ventilation disorder can cause various respiratory complications. If the disorder occurs, for example, as part of chronic bronchitis, the typical symptoms, i.e. cough, sputum and shortness of breath, increase as the disease progresses and are associated with a shorter life expectancy. A possible secondary disease is tachycardia, abnormal heart palpitations, which can lead to further diseases of the cardiovascular system.
Furthermore, cyanosis, in which the skin turns blue, can occur in connection with a persistent ventilation disorder. In the course of the disorder, dyspnea on exertion or dyspnea at rest often occurs if the underlying disease is severe. Ventilation disorders in the context of an acute asthma attack can lead to acute shortness of breath. In extreme cases, symptoms of suffocation and a panic attack can occur.
An untreated disturbance of the ventilation is particularly problematic, because this can cause consequential damage to the brain (due to chronic lack of oxygen) and the lungs in the later stages. During treatment, the risks mainly come from the prescribed drugs, which are often associated with side effects and interactions.
When should you go to the doctor?
Disorders of breathing activity should always be clarified by a doctor if they persist for several weeks or months. In the event of acute shortness of breath, consult a doctor immediately. If there is a loss of consciousness due to the lack of oxygen, an emergency service must be alerted. In addition, mouth-to-mouth resuscitation from the first aid catalog must be used by those present. This is the only way to ensure the survival of those affected. Dizziness, unsteady gait, general weakness or disturbances in attention and concentration indicate health irregularities that should be clarified by a doctor.
A pale complexion, irregular heart rhythm and sleep disturbances are other complaints that need to be investigated. Heavy breathing, pauses in breathing and general dysfunction are signs of a ventilation disorder. In order for a treatment plan to be drawn up, a diagnosis must be made by a doctor. If everyday obligations cannot be met or if there are problems in coping with sporting tasks, it is advisable to clarify the cause.
In the event of an inner feeling of pressure, general malaise and a tendency to tire quickly, the observations should be discussed with a doctor. The loss of joie de vivre, apathy and withdrawal from social life should be interpreted as warning signs. A doctor’s visit is advisable so that the reasons for the health impairments can be determined.
Treatment & Therapy
The treatment of a ventilation disorder is always aimed at treating the underlying disease that caused it. If it is from long-term inhalation of toxic fumes or dust, or from cigarette smoke, the first part of therapy is to avoid the substances in the future. The next stage of treatment is usually treatment with beta2 mimetics called bronchodilators to relax the vascular muscles of the airways and allow the airways to widen.
The medication can also be taken in the form of breathing sprays. This has the advantage that the active substance can be brought directly to the affected tissue in a simple manner. If chronic inflammation of the airways is one of the causes of the ventilation disorders, corticosteroids are often used. However, with long-term use of cortisone, its side effects must also be considered, which can include a weakening of the immune system against infections.
In some cases where chronic oxygen deficiency already exists, supplemental oxygenation via a mask may be required. In very severe cases, for example, airways that have been narrowed and totally obstructed by surgical interventions can be reopened or bypassed. As a last resort, lung transplants are also performed if the condition cannot be treated.
Prevention
Direct preventive measures that could prevent a ventilation disorder do not exist because the disease is either based on a causative underlying disease or is based on the inhalation of long-term toxic dusts or aerosols. If it is not possible to keep away from certain toxic substances – including cigarette smoke – it is advisable to carry out lung function tests at regular intervals of around three to five years.
The ventilation disorder represents an everyday burden for the patient. Due to frequent breathing difficulties, many of those affected are dependent on breathing apparatus. Follow-up care is advisable to restore or maintain quality of life. The patient should be proficient in the everyday use of breathing aids. At follow-up appointments he learns the correct use of such aids.
Aftercare
A ventilation disorder can have acute and chronic causes. Duration and scope of follow-up care therefore depend on the underlying disease. Close follow-up care is required for chronic lung diseases such as COPD or bronchial asthma, which the pneumologist uses over the long term. In the case of an acute trigger, the actual disease is eliminated.
As part of the aftercare, the specialist will check whether the condition is improving. The follow-up examinations are continued until the symptoms have subsided. The patient is prescribed medication to relieve the build-up of secretions and coughing. In addition, aftercare includes people close to you.
You will be informed about first aid measures. Acute shortness of breath can be recognized in good time and first aid given. A balanced diet rich in vitamins, avoiding too high a stress level and going to self-help groups all contribute to improving the condition. In this case, follow-up care is more like preventive care.
You can do that yourself
Depending on the severity of the underlying disease, a ventilation disorder can significantly reduce the affected person’s quality of life. From a psychological point of view, it is primarily important to maintain the social environment.
A sudden worsening of the disease in particular can lead to inability to work and social problems. The consequences are often depression and a further deterioration in the state of health. The exchange with other affected people in forums or self-help groups breaks this downward spiral. Those affected not only find experiences there, but also receive up-to-date information on doctors, sports groups and other contact points.
From a medical point of view, the compliance of the patient with the therapy is particularly important. Regular discussions with the doctor facilitate the implementation of a well-coordinated therapy. Special lung sports are particularly important in the case of a ventilation disorder. Those affected can support these measures themselves by doing sports at home and staying physically active. In addition, general measures such as sufficient rest and avoidance of stress apply . Diet may need to be adjusted to accommodate the progressive disease. The association COPD Germany e. V. can provide those affected with further tips and measures for treating a ventilation disorder.
