Causes of Respiratory Failure

Written by Han Shun Li
Pulmonology
Updated on December 17, 2024
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Respiratory failure is relatively common in clinical practice and is frequently seen in critical respiratory conditions. The causes of respiratory failure most often arise from diseases of the respiratory and circulatory systems, such as chronic obstructive pulmonary disease, acute exacerbation of asthma, severe pneumonia, severe pulmonary tuberculosis, diffuse pulmonary fibrosis, pulmonary edema, pneumoconiosis, pulmonary embolism, various causes of heart failure, pulmonary hypertension, severe pneumothorax, and substantial pleural effusion, among others. These can all lead to respiratory failure. Therefore, if respiratory distress occurs clinically and respiratory failure is suspected, it is crucial to conduct prompt examinations and actively manage the condition.

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Written by Han Shun Li
Pulmonology
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What are the symptoms of respiratory failure?

Respiratory failure is a common critical illness in clinical settings, characterized by serious impairments in the lung's ventilation and gas exchange functions. What are the symptoms after respiratory failure? First and foremost, the earliest and most obvious symptom is difficulty breathing. Many patients experience significant difficulty breathing; severe cases may even involve orthopnea, profuse sweating, and inability to speak. Another important symptom is cyanosis, which is a typical manifestation of hypoxia. Additionally, there can be neuropsychiatric symptoms such as mental confusion, agitation, convulsions, and even coma. Other systems may also exhibit symptoms, such as tachycardia, arrhythmias, and decreased gastrointestinal function.

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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 Peng Miao Yun
Internal Medicine
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Respiratory failure is a disease.

Respiratory failure is a condition caused by severe impairment of lung ventilation and gas exchange functions due to various reasons, leading to ineffective gas exchange. This results in hypoxia in the body, accompanied by either retention or non-retention of carbon dioxide, thereby causing a clinical syndrome of physiological and metabolic disorders. The causes of respiratory failure include diseases of the lung tissue, respiratory tract disorders, pulmonary vascular diseases, and cardiovascular and cerebrovascular diseases, among other factors, all of which can lead to respiratory failure.

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Written by Li Qiang
Intensive Care Unit
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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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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.