Respiratory failure

Extract

• Respiratory failure is caused by a disturbance in gas exchange on the alveolar level or a disturance of pulmonary ventilation, or – in most cases – by both. The former leads to hypoxemia, the latter to hypercapnia.
• The condition derives from a disturbance in the function of the respiratory centre or in the function of the nerves, respiratory muscles, chest, lungs or pulmonary circulation that play a role in breathing. The condition may be acute or chronic.
• Acute symptoms include subjective breathing difficulty, increased work of breathing, restlessness/anxiety, confusion and disturbances of consciousness. Symptoms of chronic respiratory failure include dyspnoea, restless sleep, daytime fatigue, cyanosis, polycythaemia and signs of increased workload of the right heart.
• A pulse oximeter reveals a disturbance in the gas exchange (hypoxemia), but not impaired ventilation (hypercapnia), the detection of which requires determination of carbon dioxide concentration by arterial blood gas analysis, capillary sample or skin carbon dioxide measurement.
• In an acute situation, it is most important to ensure an open airway and adequate oxygen supply to the tissues, and to rapidly begin the symptomatic treatment of the underlying cause.
• In chronic respiratory failure, the primary treatment is assisting ventilation with a bilevel positive airway pressure (BiPAP) ventilator, combined, as necessary, with oxygen therapy.

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Anaesthesiology, BiPAP, Continuous Positive Airway Pressure, Dyspnea, Hypercapnia, Internal medicine, J96.0, J96.1, Lung Diseases, Obstructive, Oxygen, Oxygen Inhalation Therapy, Pulmonary Disease, Chronic Obstructive, Pulmonary Ventilation, Pulmonary diseases, Respiration, Artificial, Ventilation, acute respiratory insufficiency, anoxemia, gas exchange disturbance, obstruction, oxygen partial pressure, respiratory failure