Can respiratory failure be cured?

Written by Li Fang Xiao
Internal Medicine
Updated on September 12, 2024
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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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Intensive Care Medicine Department
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How to administer oxygen for respiratory failure.

First, we should evaluate whether the patient has type I or type II respiratory failure based on arterial blood gas analysis. Type I respiratory failure is primarily characterized by low oxygen tension, indicating a state of hypoxia, with normal carbon dioxide tension, in which case high-flow oxygen therapy can be administered. In type II respiratory failure, both the oxygen tension is low and the carbon dioxide tension is high. In this case, only low-flow oxygen therapy should be given, or non-invasive ventilation, or endotracheal intubation connected to mechanical ventilation may be employed.

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What are the symptoms of respiratory failure?

Respiratory failure is a common critical condition in clinical settings. At the stage of respiratory failure, patients often experience severe discomfort and pain. Common symptoms include difficulty breathing, with many patients showing obvious respiratory distress, often needing to sit upright to breathe, profuse sweating, and an inability to continue normal activity. Additionally, cyanosis can occur, indicating very severe hypoxia. Symptoms of pulmonary encephalopathy, such as mental confusion, convulsions, and agitation, may also appear. In severe cases, patients may even fall into a coma. Hence, at the stage of respiratory failure, patients suffer considerably.

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The earliest clinical symptoms of respiratory failure

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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Precursors of respiratory failure

Respiratory failure can be a very acute condition, or it may evolve gradually due to chronic diseases. The basic precursors of respiratory failure generally include hypoxia or hypercapnia. In the early stages of hypoxia, patients may experience excitement or irritability, characterized by rapid breathing and possibly sweating due to the effort of breathing. Symptoms include accelerated breathing and hypoxia; the patient’s lips may also turn blue. If the level of carbon dioxide increases, once past the initial period of excitement and as the hypoxia worsens, the person may become listless. Gradually, their consciousness may become unclear, manifesting as drowsiness or possibly even coma.

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Clinical manifestations of respiratory failure

Respiratory failure is one of the common critical illnesses. So, what are the clinical manifestations of respiratory failure? Firstly, there is difficulty breathing, which is the most common symptom of respiratory failure. Most patients experience noticeable difficulty breathing, and in severe cases, patients may sit upright to breathe, sweat profusely, and appear very distressed. Another symptom is cyanosis, a typical sign of oxygen deficiency. Mild cases may show cyanosis at the extremities and lips, while severe cases can exhibit cyanosis throughout the body. Additional symptoms can include neurological and psychological symptoms such as confusion, mania, convulsions, coma, and drowsiness. Due to the oxygen deficiency affecting various systems, other systems may also show corresponding symptoms, such as tachycardia and arrhythmia in the circulatory system, and potential upper gastrointestinal bleeding in the digestive system.