The earliest clinical symptoms of respiratory failure

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 10, 2024
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The clinical symptoms of respiratory failure mainly manifest as hypoxemia and carbon dioxide retention. Looking at their clinical manifestations, mild hypoxia may not show any clinical symptoms. As the severity of the disease increases, there can be signs of increased respiratory drive, such as rapid breathing or difficulty breathing, along with symptoms of sympathetic nervous system activation, such as anxiety and sweating. Hypoxemia can cause dilation of peripheral arteries and constriction of veins, leading to an increased heart rate, or even severe arrhythmias. Furthermore, considering the clinical manifestations of carbon dioxide retention, they are directly related to the levels of carbon dioxide in the body, mainly depending on the rate of occurrence. Clinically, this primarily affects myocardial contractility, the contractile ability of respiratory muscles, and increases in intracranial blood flow. In mild to moderate cases, it can stimulate the respiratory center causing increased and shallow breathing, but in severe cases, it may suppress the respiratory center.

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What are the symptoms of respiratory failure?

Respiratory failure is a common and serious condition in clinical settings, often categorized as an acute and critical illness. Simply put, respiratory failure occurs when respiratory function is extremely poor. It is caused by severe impairment of pulmonary ventilation and gas exchange due to various reasons. Even at rest, sufficient gas exchange cannot be maintained, leading to serious hypoxemia or concurrent hypercapnia. Clinically, this often presents with severe breathing difficulties, hypoxia, cyanosis, and requires immediate intervention to prevent potentially life-threatening complications.

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Is respiratory failure serious?

Respiratory failure is a relatively severe disease, with the most common causes being chronic obstructive pulmonary disease (COPD) or heart failure, which are frequently seen in clinical settings. Respiratory failure can be definitively diagnosed by performing blood gas analysis. Clinically, patients will exhibit symptoms of breathing difficulty, such as orthopnea or wheezing. In blood gas analysis, oxygen saturation is often below 90%, and the partial pressure of oxygen is less than 60 mmHg. These indicators can diagnose respiratory failure. Although respiratory failure is a serious condition, it can be recoverable through active symptomatic treatment, identifying the underlying cause, and eliminating aggravating factors.

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Can respiratory failure be cured?

Respiratory failure is a critical condition in clinical settings, characterized by high mortality rates and the potential to impair multiple organ functions, thus endangering the lives of patients. However, in cases of chronic respiratory failure, it is generally incurable, as the respiratory function of these patients has already declined significantly. For patients with acute respiratory failure, the possibility of recovery is closely tied to the ability to diagnose early and administer effective treatment promptly. If acute respiratory failure is treated effectively early on by removing the trigger and the cause, and if the respiratory function can significantly improve within a short time, then there is still a chance for a cure.

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Respiratory failure classified by etiology

Respiratory failure can be classified according to its causes into four types. The first type involves diseases of the airway such as bronchial inflammation, bronchiectasis, and foreign body obstruction, leading to insufficient ventilation. The second type is due to lung tissue diseases, such as pneumonia, severe tuberculosis, emphysema, diffuse pulmonary fibrosis, adult respiratory distress syndrome, etc., causing a state of hypoxia and carbon dioxide retention due to ventilatory defects. The third type includes pulmonary vascular diseases, such as pulmonary vascular embolism and pulmonary infarction, which cause part of the venous blood to flow into the pulmonary veins, resulting in hypoxia. The fourth type involves diseases of the thoracic cage such as chest trauma, surgical trauma, pneumothorax, and pleural effusion, which affect daily activities and lung expansion, leading to insufficient lung ventilation and resulting in respiratory failure.

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How to rescue respiratory failure

Respiratory failure is a very serious condition clinically, and if not handled promptly, many patients may have their lives endangered. The emergency measures for respiratory failure include the following. First, it is necessary to maintain the patency of the airway. If the patient is unconscious, the patient should be placed in a supine position with the head tilted back, the lower jaw lifted, and the mouth opened to clear the airway of secretions and foreign objects. If this is insufficient, tracheal intubation and other methods should be considered to maintain airway patency. Additionally, oxygen therapy, which involves inhaling oxygen, can correct the patient's hypoxic state. If the respiratory function is very poor, consideration should also be given to using a ventilator to assist breathing. Other emergency measures include etiological treatment, supportive treatment, and protecting the function of other vital organs, among others.