Respiratory failure

As respiratory failure or respiratory failure a failure of the external ( mechanical ) is called respiration, ( alveolar hypoventilation ) leading to decreased ventilation of the pulmonary alveoli, the result of a disability of gas exchange in the alveoli is (pulmonary diffusion disorder) or a decreased ventilation of different parts of the lungs (pulmonary distribution fault) causes. In all cases there is a change in blood gas values. Referring to the different causes of reference is divided in this limited ventilation of the lungs in obstructive and restrictive ventilatory disorders.

Classification

A distinction Partialinsuffizienz, wherein the oxygen partial pressure falls in arterial blood, the carbon dioxide can not, however, be compensated for by the global failure in which both parameters are changed pathologically.

Be on time course oriented insufficiencies divided into acute and chronic forms.

Chronic respiratory insufficiency

This form is by far the more frequent. As a result, occur individually vary in severity experienced shortness of breath, cough, poor performance and possibly cyanosis. Clinical signs such as clubbing and Watchglass can only be observed with prolonged course. The causes of chronic respiratory insufficiency, chronic bronchitis, pneumoconiosis, pulmonary emphysema or tumors come into question. Even after surgery with removal of lung lobe ( lobectomy ) or one lung ( pneumonectomy ) Respiratory failure can occur.

Acute respiratory failure

The cardinal symptoms are the same as in the chronic form. The sudden onset, however, a strong affective reaction is often added with fear and suffocation. As acute causes clinically severe pneumonia, aspiration ( inhalation ) of foreign objects or water ( drowning), and injury of the lung ( pneumothorax) are possible. The acute asthma attack is an example of paroxysmal ( paroxysmal ) Respiratory dysfunction dar. Severe systemic diseases can lead to the image of the adult respiratory distress syndrome (ARDS), also occurs rapidly to a critical respiratory insufficiency.

In cardiac decompensation with formation of pulmonary edema ( heart failure, myocardial infarction ) or pulmonary vascular laying ( pulmonary embolism ), shortness of breath as a symptom is typical, prognostically important, however, is usually less the lungs, but the heart function.

In addition to these disturbances of lung function itself is also an impairment of the respiratory center in the brain stem, such as poisoning by opiates lead to acute respiratory failure ( respiratory depression ). As a leading symptom in this case, no shortness of breath, instead it comes quickly to disturbances of consciousness and at worst death.

Therapy

In therapy, the treatment of the underlying disease has priority. Symptomatic improvement can be achieved by administration of oxygen via a nasal tube. In some cases ( ventilation insufficiency, early respiratory global insufficiency ) with elevated CO2 levels, the supply of oxygen with simultaneous mechanical ventilatory support ( ventilator ) is possible.