Respiratory failure
Respiratory failure is a condition of the body of a pathological nature, during which the external respiration system does not provide a normal blood gas composition or it is achieved only with increased work of breathing (shortness of breath).
This disease can be diagnosed by a reduced oxygen partial pressure of 45 mm Hg. Art.
Respiratory failure classifications
There are several classifications of this disease.
1. Classification by pathogenetics.
- Ventilation;
- Parenchymal.
Ventilation is characterized by hypercapnia and hypoxemia (hypoxemia can be easily treated with oxygen therapy). The reasons for the appearance are:
- weakness or fatigue of the muscles responsible for breathing;
- mechanical defect of the musculoskeletal frame of the chest;
- dysfunction of the center responsible for breathing.
- kyphoscoliosis;
- heavy weight;
- damage to the muscles responsible for the respiratory function;
- COPD.
During the parenchymal form, hypoxia is observed, which is difficult to correct with oxygen therapy. This classification arises due to:
- pneumonia;
- cardiogenic pulmonary edema;
- RDSV.
2. Classification by the rate of development.
- chronic respiratory failure;
- acute respiratory failure.
The chronic form can develop gradually and imperceptibly for several months or years, as well as after incomplete recovery in the acute form.
Acute respiratory failure can develop in a few minutes, hours or days, is life-threatening and in almost all cases develops together with hemodynamic disorders. It can also develop if a person already has a chronic form (due to exacerbation or decompensation of a chronic form of respiratory failure).
3. Classification by degrees of severity.
There are three degrees of respiratory failure according to the severity of the course.
In the first degree (minor), shortness of breath sometimes occurs, the resting pulse is about 80 beats per minute and there is no or insignificant cyanosis.
In the second degree (moderate), shortness of breath occurs even during normal exertion, the pulse tends to increase, and cyanosis is distinct or significant.
During the third degree of respiratory failure (pronounced), shortness of breath is observed even in a calm state, the pulse is very rapid, and cyanosis is diffuse, pronounced.
Emergency care for acute respiratory failure
Emergency care for acute respiratory failure is to restore and maintain free patency and drainage of the airways, eliminate concomitant abnormalities in blood circulation, improve gas exchange in the lungs and alveolar ventilation.
To ensure a clear airway, the patient must first be placed in the correct position. Often, violations of patency in the pharynx are caused by a retraction in the hypopharynx of the tongue. In the larynx, trachea and bronchi, obstruction can cause foreign bodies to enter, accumulation of pathological secretions, edema or spasm, as well as compression of the airways due to mechanical injury or swelling. The first thing to do is to place the victim on their right side.
To prevent and eliminate the sinking of the tongue, the lower jaw is brought forward and, at the same time, hyperextension is performed in the occipital-cervical joint. To do this, it is necessary with the help of pressure with thumbs to move the lower jaw down, and then with the fingers located in the corners of the jaw, push it forward, while simultaneously overbending the head back. These manipulations will help to quickly restore patency in the pharynx.
Tongue sinking is also prevented with the help of special oral ducts. Before their introduction, the oropharynx is cleaned with gauze wipes or the secretion is sucked off with an aspirator.
You can also provide emergency care with tracheal intubation, conicotomy or tracheotomy.
Respiratory failure treatment
Combined treatment of respiratory failure. First you need to determine the type and degree of respiratory failure and how quickly it develops. It is necessary to treat both the failure itself and the cause that leads to it.
Oxygen therapy is mainly used to treat respiratory failure. In cases where respiration and blood gas composition do not improve, non-invasive assisted ventilation with two-level positive pressure is performed. If this does not help, the use of invasive mechanical ventilation is recommended. At the same time, it is necessary to treat the underlying disease with antibiotic therapy. The lungs should be ventilated until good spontaneous breathing is fully restored.
Respiratory failure in children
There are many reasons for respiratory failure in children. It occurs in children due to diseases of the respiratory tract, airway obstruction after regurgitation or vomiting, lung parenchyma, tongue retraction, trauma or diseases of the central nervous system, muscular dystrophies, myasthenia gravis, as well as after ingestion of foreign bodies or chest trauma.
It is possible to identify respiratory failure in a child by hypoxemia, hyper- and hypocapnia. It should be noted that hypercapnia does not develop without hypoxemia - they are combined.
Hospitalization for third degree respiratory failure is mandatory.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
