How to rescue respiratory failure

Written by Han Shun Li
Pulmonology
Updated on April 09, 2025
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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 Li Bing
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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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 Wei Shi Liang
Intensive Care Unit
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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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Written by Peng Miao Yun
Internal Medicine
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Care for patients with respiratory failure

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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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.