Respiratory failure

Respiratory failure is the inability of the lungs to supply sufficient oxygen into the blood or the lungs ineffectively removing enough carbon dioxide from the blood.

Types of respiratory failure:

There are two types of respiratory failure.

1. Acute respiratory failure - also known as Acute Respiratory Distress Syndrome. This is short term, developing suddenly and often requires emergency treatment.
2. Chronic respiratory failure - This usually develops over a longer period of time and lasts longer.

Acute Respiratory Distress Syndrome

Also referred to as ARDS. This a life-threatening condition which usually arises as a result of a complication of another infection or disease, such as cystic fibrosis.

Symptoms:

• Shortness of breath
• Shallow breathing
• Rapid breathing
• Tiredness and drowsiness
• Confusion
• Feeling faint

Causes:

Develops due to severe inflammation of the lungs, caused by an infection or injury. This inflammation causes fluid from blood vessels near alveoli to leak into the alveoli, causing difficulty in breathing.

Chronic respiratory failure is an illness which gets worse over time

Diagnosis:

Various assessments must be carried out to identify ARDS in order to eliminate any other possible health conditions that could be leading the symptoms experienced by the patient. These examinations include:

• Physical examinations
• Blood tests
• Pulse extremity test
• chest X-ray
• Echocardiogram

Treatment:

Admission to ICU is usually common and the patient will likely be put on a ventilator in order to maintain sufficient ventilation. Sometimes, in minor cases, an oxygen mask will be sufficient to correct breathing, whilst in more severe cases a tube must be inserted into the throat and lungs so oxygen can be pumped in.

Fluids and nutrients will be administrated through a feeding tube via the nose and into the stomach.

Any underlying causes of the syndrome should be identified and treated. If it is a bacterial infection, the appropriate antibiotics will be administered,

Complications in ARDS can occur, and this may result in patient death. 1 in 3 people who develop ARDS will die.

Effects after treatment:

Patients surviving ARDS will often suffer from nerve and muscle damage leading to increased pain and weakness.

Chronic Respiratory Failure

Can be classed as hypoxemic (when blood oxygen levels are low) or hypercapnic (High carbon dioxide levels).

Causes:

Usually occurs due to damage to the bronchioles become narrowed, leading to a lack of oxygen being moved into the lungs. This reduces the oxygen entering the blood, so body cells around the body will receive less oxygen.

Various lung diseases lead to this and this includes:

• Chronic obstructive pulmonary disease (COPD)
• Pneumonia
• Cystic fibrosis
• Spinal cord injuries
• Stroke
• Muscular dystrophy
• Chest injury
• Drug or alcohol abuse
• Smoking

Symptoms:

• Shortness of breath
• Coughing up mucus
• Wheezing
• Blue tint to skin and lips
• Rapid breathing
• Fatigue
• Anxiety.
• Confusion

In severe cases, patients will experience an abnormal heart rhythm or slip into a coma.

Diagnosis:

Usually diagnosed by a physical examination alongside medical history, symptoms. Other tests may then be used to confirm the diagnosis. These include: 

• Pulse oximetry test
• Arterial blood gas test
• Imaging tests

Treatment:

Often use long-term management for treatment.

• Oxygen therapy - uses portable oxygen tanks to administer constant oxygen, usually through a nasal supply. This is to ensure the body is receiving enough oxygen to function properly.
• Tracheotomy - a tube is placed in the windpipe in order to make breathing easier.
• Mechanical Ventilation - Used to breath for you in severe cases of chronic respiratory failure.

References

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