Treatment principles for respiratory failure

Written by Han Shun Li
Pulmonology
Updated on November 30, 2024
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Respiratory failure is a common emergency condition in the respiratory system, with patients often experiencing significant breathing difficulties, cyanosis, etc. So, what are the principles of treatment for respiratory failure? The overall principles of treatment are to enhance respiratory support, including maintaining airway patency, correcting hypoxia through oxygen therapy, and improving ventilation with the use of ventilators, among other measures. Additionally, it is important to intensify treatment of the causes and inducers of respiratory failure, such as controlling infections. Attention should also be paid to general supportive treatment, such as nutritional support, correcting electrolyte imbalances, etc., as well as protecting other vital organs, like the liver and kidneys.

Other Voices

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Written by Li Fang Xiao
Internal Medicine
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Is respiratory failure uncomfortable?

Respiratory failure is quite uncomfortable, and clinically, the symptoms feel severe, and the patient's own state is also very affected. Respiratory failure is mainly caused by a decrease in oxygen partial pressure, during which time the patient may experience wheezing, chest tightness, and even a feeling of being near death. There are many causes of respiratory failure, with severe infections being common, such as severe pneumonia or sepsis. A systemic inflammatory response can lead to respiratory failure. Another situation is when heart failure occurs, which can also accompany pulmonary congestion, causing pulmonary ventilation dysfunction that can also lead to respiratory failure. The treatment of respiratory failure focuses on removing the causative factors and selectively choosing different treatment plans, which can start with oxygen therapy or the use of a ventilator in severe cases to correct hypoxemia and sustain life.

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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 Wang Xiang Yu
Pulmonology
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Is respiratory failure contagious?

First, it's important to understand what respiratory failure is. Respiratory failure is a syndrome, not a disease, meaning it can result from many causes. For instance, airway obstruction, lung tissue pathology, diseases of the pulmonary vessels, and diseases of the thorax and pleura, as well as neuromuscular diseases, can all lead to impaired ventilation or gas exchange in the lungs. This impairment makes it impossible for the body to maintain adequate gas exchange even in a resting state, resulting in hypoxemia, with or without hypercapnia, which is referred to as respiratory failure. Therefore, there are many causes of respiratory failure, and some diseases are indeed contagious, such as SARS, H1N1, and H3N2. However, other causes, such as tumors or pulmonary embolism, are generally not contagious.

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Written by Yuan Qing
Pulmonology
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Can people with respiratory failure exercise?

Whether people with respiratory failure can exercise depends mainly on whether the respiratory failure occurred acutely or chronically. Generally, it is usually advised against exercising during acute respiratory failure, such as severe pulmonary inflammation, drowning, or failure of the nervous system functions. Exercise during this time can worsen the body's oxygen deficit and increase oxygen consumption, potentially exacerbating the symptoms of the disease. However, for chronic respiratory failure, such as chronic obstructive pulmonary disease (COPD) or chronic pulmonary interstitial fibrosis, patients have long been enduring hypoxia or hypercapnia. These individuals can engage in appropriate respiratory rehabilitation exercises, such as respiratory rehabilitation gymnastics and some traditional Chinese medicine practices, which can greatly aid in the recovery from the disease, particularly respiratory failure. The decision primarily depends on the patient’s specific condition and their physical tolerance.

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Written by Li Tao
Pulmonology
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What is acute respiratory failure?

Respiratory failure refers to the severe dysfunction in pulmonary ventilation and gas exchange in the respiratory system caused by various reasons under normal conditions. This dysfunction leads to ineffective gas exchange during respiration, resulting in hypoxia in the body and retention of carbon dioxide, thereby causing a series of physiological and metabolic disorders. Typically, under resting conditions at sea-level atmospheric pressure, respiratory failure is defined when arterial oxygen tension falls below 60 mmHg, accompanied by carbon dioxide retention, with carbon dioxide tension exceeding 50 mmHg, or without an increase in carbon dioxide tension. It is categorized into acute respiratory failure and chronic respiratory failure.