bubble_chart Overview

Respiratory failure is a clinical syndrome caused by severe respiratory dysfunction due to various reasons, leading to a decrease in arterial oxygen partial pressure (PaO₂), with or without an increase in arterial carbon dioxide partial pressure (PaCO₂), resulting in a series of pathophysiological disturbances. It is a state of dysfunction rather than a disease itself, which can be caused by lung diseases or as a complication of various diseases.

bubble_chart Diagnosis

1. Medical History and Symptoms:

(1) Often have a history of bronchial, pulmonary, pleural membrane, pulmonary vascular, cardiac, neuromuscular, or severe organic diseases. (2) In addition to the symptoms of the primary disease, the main manifestations are hypoxia and carbon dioxide retention, such as dyspnea, tachypnea, neuropsychiatric symptoms, etc. When complicated with pulmonary encephalopathy, there may also be gastrointestinal bleeding.

2. Physical Examination Findings:

There may be cyanosis, impaired consciousness, conjunctival congestion, edema, flapping tremor, optic disc edema, etc.

3. Auxiliary Examinations:

(1) Blood gas analysis; at rest breathing air, the arterial oxygen partial pressure (PaO₂) <8.0Kpa (60mmHg), arterial carbon dioxide partial pressure (PaCO₂) >6.7Kpa(50mmHg) indicates type II respiratory failure, while a simple decrease in arterial oxygen partial pressure indicates type I respiratory failure. (2) Other examinations will have corresponding findings depending on the primary disease.

bubble_chart Treatment Measures

1. Mild cases can be treated on an outpatient basis, while severe cases should be hospitalized. The primary disease should be actively treated first, and antibiotics should be used in case of infection to eliminate the inducing factors.

2. Maintain airway patency and effective ventilation. Medications to relieve bronchospasm and dispel phlegm, such as salbutamol (Ventolin), terbutaline sulfate (Bricanyl), acetylcysteine (Mucomyst), and bromhexine hydrochloride (Bisolvon), can be administered. If necessary, nikethamide and corticosteroids can be administered intravenously.

3. Correct hypoxemia by using nasal cannula or mask oxygen therapy. In cases of severe hypoxia accompanied by carbon dioxide retention (PaO₂ < 7.32 kPa (55 mmHg)), significantly increased PaCO₂, or severe consciousness disorders leading to pulmonary encephalopathy, mechanical ventilation should be used to improve hypoxemia.

4. Treat complications such as acid-base imbalance, arrhythmia, and heart failure (refer to relevant chapters).