Respiratory failure often occurs in people with various lung conditions. With bronchitis, pneumonia, asthma, chronic obstructive pulmonary disease, there may be a lack of oxygen, which leads to tissue hypoxia throughout the body. Respiratory is not important enough to notice and compensate in time, otherwise irreversible changes may begin in the patient's body. You can read more about the degrees of DN, classification and treatment methods in this article.
What is respiratory failure?
Normal blood gases are a combination of carbon dioxide and oxygen. The norm for carbon dioxide is about 45%, this percentage allows you to activate the respiratory center and control the depth and frequency of inhalations and exhalations. The role of oxygen is also clear: it saturates the entire body, getting into the blood and being transferred to the cells with the help ofcompounds with hemoglobin. Respiratory failure is manifested in a change in the gas composition of the blood. The inability of the body to provide a proper supply of oxygen may initially be compensated for by other body systems. But with such a load, the human body is very quickly depleted, and DN manifests itself more clearly. That is why doctors strongly advise you to pay attention to your well-being and take all tests on time.
The human respiratory system is closely related to the circulatory system. Violations in the work of one of the functions are compensated by the increased work of the other. For example, if it becomes difficult for the patient to breathe, the heart begins to beat faster in order to have time to saturate all the tissues with oxygen. If this measure does not help, and hypoxia increases, then the body begins to increase the production of red blood cells and hemoglobin. If this continues for a long time, then the body's capabilities decrease, and it becomes unable to maintain normal blood gas exchange.
Causes of NAM
Respiratory failure syndrome is most commonly seen in preschool children and the elderly. This is due to the fact that their lungs cannot cope with the load placed on them, and even a simple SARS can worsen the condition. What other causes of respiratory failure are there?
- Congenital and acquired pathologies of the central nervous system. Our breathing is a complex mechanism that is regulated by the respiratory center of the medulla oblongata. It is one of the oldest systems in our body.but it can also be impaired as a result of head injuries or congenital pathologies of the central nervous system.
- Drug and alcohol intoxication can be harmful, in severe cases, the patient lives only under mechanical ventilation.
- Prematurity. If a child is born too early, his respiratory center does not have time to form, so DN develops.
- Infections affecting the nervous system (botulism, meningitis).
- Lung diseases (pneumonia, bronchitis, COPD).
- Increased blood pressure in the pulmonary vessels.
- Formation of pathological connective tissue in the lungs.
- Severe stages of curvature of the spine can significantly affect the volume of the chest, causing chronic respiratory failure.
- Lung abscess.
- Heart defects (open foramen ovale, etc.).
- Low hemoglobin.
- Imbalance of thyroid hormones.
- Rare genetic diseases (SMA).
- Changes in the lungs at the structural level due to smoking or damage by corrosive gases.
Respiratory failure develops under various pathological conditions, often the cause can be a banal lack of physical activity and weak muscle tone. But, despite the huge list of prerequisites, NAM can be prevented by engaging in timely prevention.
Classification
The severity of changes in the gas composition of the blood depends on the severity of the respiratoryinsufficiency. Experts distinguish four stages of the disease:
- Respiratory failure 1 degree begins with difficulty inhaling. A person has to make more efforts to breathe, pectoral muscles are connected to work. At this stage, the patient is already beginning to sink the triangle between the ribs in front of the chest. Small children begin to behave restlessly. Babies often cry, they may experience intermittent cyanosis, which improves while breathing oxygen. At night, the patient's condition usually worsens, as the activity of the respiratory center decreases.
- DN 2 degrees can be easily recognized by noisy breathing, which is audible even at a distance of several meters from the patient. Due to the effort that the body has to make to breathe, the patient sweats a lot and experiences general muscle weakness. The symptoms are accompanied by a cough, pallor of the skin, an altered voice.
- Respiratory failure of the third degree is already the penultimate stage of the disease, in which the patient can only be in the hospital. The patient has a pronounced shortness of breath with a strong retraction of the chest. All the forces of the body are rushed to maintain the function of breathing, so the person is passive and apathetic. Changes are also taking place in the circulatory system: the heart suffers, blood pressure drops and tachycardia begins.
- DN 4 degrees is a fatal degree of the disease. It is practically untreatable. Respiratory arrest is often observed at this stage. As a result, the patient develops encephalopathy, convulsions,coma.
Respiratory failure 1 degree is the most easily treatable stage of the disease. During this period, many changes in the body can still be prevented, which then cannot be reversed.
Classification of respiratory failure
Respiratory failure has not only different degrees of severity, but also a different classification. Depending on the cause of the disease, the following types of DN are distinguished:
- Obstructive - characterized by blockage of the alveoli in the bronchi by various foreign bodies. It can be either foreign bodies (for example, small objects), or mucus and pus. For example, in bronchitis and pneumonia, the alveoli are clogged with viscous sputum, which reduces the effective volume of breathing and, as a result, leads to respiratory failure. Fortunately, this type of disease is easily reversible, it is enough just to take timely measures to cure the underlying disease.
- Hemodynamic DN occurs when there is a violation of the blood circulation of the lung area. As a result, the necessary amount of oxygen ceases to flow into the blood.
- Diffuse type of respiratory failure is also called respiratory distress syndrome. The reason for its formation is the thickening of the septum between the alveolus and the blood vessel. As a result, oxygen does not penetrate into the blood, and the body lacks this gas. In children, this type of DN occurs due to prematurity and immaturity of the alveoli.
- The restrictive degree of DN appears due to structural changes in the lung tissue, whichloses its elasticity and begins to perform its function worse. Restrictive DN is formed with pneumothorax, pleurisy, kyphoscoliosis.
Acute and chronic NAM
The organs of the chest are closely interconnected. Respiratory failure can take several years to develop before a person realizes what is wrong and takes action. Depending on the severity, two degrees of DN are distinguished:
- Spicy.
- Chronic.
Acute respiratory failure starts suddenly and develops very quickly. Literally in a matter of minutes, the patient's condition can noticeably worsen. Young children who have underdeveloped lungs are especially at risk of developing acute DN. The acute period of the disease cannot be confused with anything: vital signs are rapidly deteriorating, the person turns pale, breathing becomes difficult. Often the cause of acute respiratory failure is various injuries or poisoning with chemicals that disrupt gas exchange in the body. Encephalopathy, coma, or death may result if the casu alty is not given immediate medical attention.
Chronic degree of DN develops for more than one year. At first, the patient may not even pay attention to the initial signs of the disease. However, over time, the patient's condition worsens. It is important to identify DN at the first deviations, establish its cause and cure it. If this is not possible, then it is necessary to help the body with maintenance therapy in order to prevent furtherdeterioration.
How to determine the degree of DN yourself?
It is important for every person to know the first symptoms of respiratory failure in order to recognize the disease in time. What signs can be used to identify DN?
You should show concern already when you notice the first disturbing "bells". In children, this may be anxiety and crying, previously unusual for them, and in adults - shortness of breath and a slight deterioration in the general condition. At this stage, you need to contact a specialist or at least take a blood test to control the situation. But it must be remembered that at the initial stage the body compensates for respiratory failure, so only a specialist can determine it. The first degree of DN has a vivid symptom: cyanosis of the nasolabial triangle, which 100% indicates a lack of oxygen in the blood. If the whole skin acquires a pale blue tint, then this already indicates the second stage of DN. "Marbling" occurs in the third or fourth degree of respiratory failure. Veins and vessels translucent under the skin clearly indicate that the patient needs hospitalization and urgent medical care.
Diagnosis
Causes and treatment of shortness of breath should begin to look immediately after you began to notice such changes in yourself. The following methods are used to diagnose respiratory failure:
- Collecting an anamnesis of the disease. The doctor carefully studies the patient's medical history, his complaints, learns his lifestyle.
- External examination of the patient. With the help of studying the skin, chest muscles, heart rhythm, the doctor can confirm or refute his guesses.
- Blood gas analysis is a reliable study. In the presence of deviations, a disease of the chest organs can be assumed.
The doctor makes the final diagnosis after a comprehensive diagnosis. It must be confirmed by laboratory tests.
Treatment and first aid
Treatment of respiratory failure can be divided into two types: emergency care, as well as diagnostic and symptomatic treatment of the disease. Emergency care is provided in acute DN, when the patient's condition worsens literally before our eyes. Before the arrival of the ambulance, you must perform the following sequence of actions:
- Lay the patient on the right side.
- Untie a tie, neckerchief, top button of a blouse or shirt to allow oxygen flow.
- Remove foreign bodies or phlegm from the throat with gauze (if necessary).
- If breathing stops, begin resuscitation. For example, artificial respiration and cardiac massage.
If we are talking about a chronic condition, then for the treatment of respiratory failure, it is necessary, first of all, to identify the causes of its occurrence. For this, various laboratory and diagnostic studies are carried out. The main treatment groups can be distinguished:
- Oxygen therapy or oxygen treatment. Even with mild respiratory failure, doctors resort to this method in order toavoid hypoxia in tissues and support the body. This method of treatment instantly improves the current condition of the patient, but, unfortunately, does not solve long-term problems.
- Antibacterial can cure obstructive type DN, as it acts on the bacteria and microorganisms that caused the respiratory disease.
- Hormonal drugs such as Pulmicort and Prednisolone help eliminate pulmonary edema and make breathing easier. In chronic respiratory diseases, these drugs are prescribed as maintenance therapy.
- Broncholytic and anti-inflammatory drugs ("Berodual", "Salbutomol") are prescribed to eliminate obstruction. They begin to work in a few hours.
- Mucolytic agents ("Lazolvan", "Ambroxol") are prescribed in case of dry cough and "stagnant" sputum.
- In case of a severe course of the disease with abundant sputum, drainage massage and sanitation of the upper respiratory tract are prescribed to prevent inflammation in the lungs.
- Breathing exercises can significantly improve the patient's condition if done in a timely and regular manner.
Prevention and prognosis
Any disease is easier to prevent than to cure. This is also true for respiratory failure. When complaining of shortness of breath during exercise, it is important to immediately begin preventive measures:
- Timely and adequate treatment of diseases.
- Blood gas monitoring.
- Moderate physicalload.
- Breathing exercises.
- Annual medical examination.
Complications
Here are the complications that respiratory failure can lead to:
- From the side of the heart and blood vessels. Respiratory failure increases the load on the cardiovascular system, causing specific diseases such as ischemia, hypotension, heart attack, etc.
- The digestive organs (intestines, stomach) are also at risk in respiratory failure. With this disease, you can get stomach ulcers, intestinal bleeding and irregular stools.
- The most obvious DN affects the brain and other organs of the central nervous system. The patient becomes irritable, lethargic, unable to concentrate.
- Quite often, respiratory failure leads to inflammation in the lungs (pneumonia, bronchitis).
As you can see, there are many causes of shortness of breath. Treatment must begin as soon as you notice alarming syndromes in your body. Perhaps the hot weather or your fatigue is to blame. But the syndrome of respiratory failure is a serious disease that, if not properly treated, can cause a fatal outcome of the patient. Therefore, it is important to diagnose acute and chronic DN in time and start treatment without delay.
