Clinical manifestations of respiratory failure

Written by Han Shun Li
Pulmonology
Updated on April 07, 2025
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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.

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Written by Han Shun Li
Pulmonology
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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.

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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.

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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.

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Written by Han Shun Li
Pulmonology
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Classification of Causes of Respiratory Failure

Respiratory failure, if categorized by its cause, can be divided into pump failure and lung failure. Pump failure refers to the failure of the respiratory pump, which comprises the central nervous system that drives or regulates respiratory movement, the peripheral nervous system, neuromuscular tissues, and the thoracic cage, collectively known as the respiratory pump. Respiratory failure caused by dysfunction of these components is called pump failure. Another type is lung failure, which results from airway obstruction, pulmonary tissue and vascular pathology, and is termed lung failure. Lung failure can lead to type I or type II respiratory failure, whereas pump failure typically presents as type II respiratory failure.

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Written by Peng Miao Yun
Internal Medicine
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How to administer oxygen for respiratory failure

If patients with respiratory failure undergo oxygen therapy, it is necessary to choose different therapy plans based on the type of respiratory failure. In the case of Type I respiratory failure, there is simply a lack of oxygen. For Type II respiratory failure, there is not only a lack of oxygen but also an accumulation of carbon dioxide. Therefore, for Type I respiratory failure, the oxygen flow can be higher, over five liters per minute, and the patient can continuously receive oxygen without causing significant side effects. However, for Type II respiratory failure, it is essential to control the oxygen flow at a low rate, under three liters per minute, otherwise, it may lead to other complications.