Care for patients with respiratory failure

Written by Peng Miao Yun
Internal Medicine
Updated on September 03, 2024
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Patients with respiratory failure are always emergency and critically ill patients in clinical settings. For patients with respiratory failure, we need to pay close attention in nursing: first, strictly monitor the patient's vital signs, observe the frequency of respiration, blood pressure, and consciousness state; take good care of the skin and oral cavity to prevent dependent pneumonia and bedsores; and timely remove the patient’s sputum. Encourage conscious patients to cough more and expectorate sputum. For those with weak coughs, assist regularly with turning and patting the back to facilitate the removal of sputum. For comatose patients, mechanical suction or tracheostomy for mechanical ventilation can be performed. At the same time, avoid factors that can induce respiratory difficulty such as cold air and poor air circulation. Patients with respiratory failure consume a lot of energy, especially those on mechanical ventilation, who are in a stress state with increased catabolism. Therefore, daily protein intake should be increased, encourage the patient to eat more to enhance nutrition, and provide a diet high in protein, high in fat, and low in carbohydrates.

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Written by Peng Miao Yun
Internal Medicine
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How to treat respiratory failure?

Treatment of patients with respiratory failure is primarily medical, focusing on suppressing or relieving the causes and triggers of respiratory failure, improving lung ventilation and gas exchange as much as possible, and treating and improving the function and condition of various vital organs. First, it is important to actively treat the primary disease causing respiratory failure. If there is a concurrent bacterial infection, sensitive antibiotics should be used, and triggers should be removed as much as possible. Simultaneously, maintaining airway patency and effective ventilation volume is necessary, which can involve administering bronchodilators and expectorants such as salbutamol, terbutaline sulfate, acetylcysteine, and ambroxol. When necessary, corticosteroids can be administered intravenously. If internal medicine treatment does not improve symptoms, tracheotomy and mechanical ventilation may be necessary to assist breathing. (Medications should be taken under the guidance of a physician, based on the actual situation.)

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Written by An Yong Peng
Pulmonology
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Is asthma considered respiratory failure?

Asthma and respiratory failure are two distinct concepts. Asthma is a disease, whereas respiratory failure is a clinical outcome resulting from a series of diseases. During an acute asthma attack, there is also a possibility of respiratory failure occurring, and in severe cases, it can lead to serious respiratory failure requiring interventions like tracheal intubation and mechanical ventilation. Therefore, acute asthma attacks require active intervention. Treatments often include nebulized inhalation of short-acting bronchodilators and even intravenous administration of corticosteroids to handle the acute episode. Short-term intravenous use of corticosteroids can also help in controlling the acute attack.

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Written by Peng Miao Yun
Internal Medicine
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Respiratory failure is a disease.

Respiratory failure is a condition caused by severe impairment of lung ventilation and gas exchange functions due to various reasons, leading to ineffective gas exchange. This results in hypoxia in the body, accompanied by either retention or non-retention of carbon dioxide, thereby causing a clinical syndrome of physiological and metabolic disorders. The causes of respiratory failure include diseases of the lung tissue, respiratory tract disorders, pulmonary vascular diseases, and cardiovascular and cerebrovascular diseases, among other factors, all of which can lead to respiratory failure.

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Written by Li Fang Xiao
Internal Medicine
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Can respiratory failure be cured?

Respiratory failure can potentially be cured, and the key lies in identifying the cause of the respiratory failure. For instance, acute inflammatory infections, such as severe pneumonia and other infectious diseases, can lead to dysfunction in lung ventilation and gas exchange, manifesting as respiratory failure. With the aggressive use of antibiotics and anti-infection drugs, once the infection is controlled, respiratory failure can also be corrected accordingly. Furthermore, if it is a complication of other diseases, such as acute left heart failure, respiratory failure can also occur. This type of respiratory failure will quickly improve once heart function is corrected. However, in the case of chronic diseases such as chronic obstructive pulmonary disease, bronchiectasis, asthma, and other causes, respiratory failure can only be managed with medication to alleviate symptoms, and it cannot be completely cured.

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Written by Wang Ji Zhong
Internal Medicine
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Causes of respiratory failure

Respiratory failure is a severe breathing difficulty that can lead to hypoxia and carbon dioxide retention. The causes of respiratory failure can be broadly classified into the following categories: First, there are diseases of the lung parenchyma, such as various lung infections, pneumonia, pulmonary edema, lung abscess, and diseases of the lung interstitium. Another type involves obstruction of the airway, including obstruction in the upper respiratory tract, which covers the nose, pharynx, and larynx, as well as obstructions in the lower respiratory tract, which can also lead to respiratory failure. Third, there are diseases involving the peripheral nervous transmission system and the respiratory machinery, such as acute infectious polyradiculoneuritis, poliomyelitis, and some cervical spine injuries. These can severely affect the respiratory center and respiratory nerves, leading to respiratory failure.