Respiratory failure

December 2016


Definition


Respiratory failure is the inability of the respiratory system to ensure the correct process of blood oxygenation. This may be in the form of acute respiratory failure, or more often chronic respiratory failure, which is progressive in appearance. There are two main types of respiratory failure: ventilatory respiratory failure or post-ventilation failure. In ventilatory failure, we can distinguish between obstructive symptoms, where discomfort is especially related to expiratory air flow, as is the case of asthma or bronchitis, and restrictive syndromes, where the air mobilized by the lungs is reduced, namely in the case of infiltrative lung disease or after the removal of all or part of a lung. Post-ventilatory insufficiency is secondary to an impairment of the membrane through which gas exchanges between the lung and the blood cells. Note that a neurological origin can also be at cause, either in relations to the brain, or due to an involvement of the respiratory muscles.

Symptoms


In case of respiratory failure, a lack of oxygen will cause difficulty in carrying out normal body functions. The affected person will gradually have less and less energy and tire more easily. If there is a significant decrease in blood oxygenation, cyanosis, blue coloring of the skin, may appear, especially in the extremities. Initially, few other symptoms are apparent, and the body adapts its capacity of blood oxygenation, at the cost of increasing pressure in the pulmonary arteries, which may lead to right heart failure symptoms such as tachycardia, edema of the legs, or an increasing the size of the liver. The disease progresses to left heart failure and thus is accompanied by an overall increase of respiratory discomfort and fatigue. Note that impacts on the kidney may be responsible for the stimulation of the synthesis of the hormone erythropoietin, or EPO, and consequently an increase in the thickness of the blood that increases the risk of the obliteration of vessels.

Diagnosis


Respiratory failure can be diagnosed when a person has difficulty breathing with lung ventilation accelerating during exercise or even at rest. Most of the time, however, it is discovered in a patient with a known respiratory disease, upon examination of arterial blood gases (blood in the artery) showing abnormalities in the distribution of gases in the blood: oxygen concentration is decreased while the concentration of carbon dioxide is normal or increased. Respiratory function tests are performed if the problem is more obstructive, restrictive, or mixed.

Treatment


The treatment of respiratory insufficiency is based on restoring normal breathing as much as possible, since the disease is irreversible. Treatment includes:
  • oxygenating the patient if the infringement concerns a lack of exchange between the lung and the blood cells, which is the case in most chronic respiratory failures;
  • helping to overcome the deficit of respiratory control by implementing a respirator (artificial ventilation);
  • In some cases, a lung transplant is considered.

Related

Published by Jeff. Latest update on June 14, 2013 at 05:40 PM by Jeff.
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