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Respiratory Failure

Cardio-thoracic SurgeryRespiratory Medicine

Respiratory failure occurs when the lungs cannot adequately fulfil their essential function of supplying oxygen to the body and removing carbon dioxide. It can be caused by various factors such as lung diseases, infections, injuries, or certain medications.

When someone experiences respiratory failure, they may exhibit symptoms like shortness of breath, rapid breathing, confusion, or bluish discoloration of the lips and fingertips. Prompt medical intervention is crucial to ensure proper oxygenation. This condition can be a medical emergency requiring immediate attention.

Symptoms

Respiratory failure occurs when the lungs cannot adequately perform their basic functions of supplying oxygen to the body and removing carbon dioxide. Respiratory failure has many possible causes, including bacterial or viral infections, trauma, tumours, or damage caused by certain medications.

Causes

Respiratory failure has various underlying causes, typically related to lung disorders, nervous system conditions, or muscle dysfunction:

Lung disorders: pneumonia, pulmonary oedema, chronic obstructive pulmonary disease (COPD), pneumothorax, pulmonary embolism, etc.
Airway obstruction or infection: severe asthma attacks, acute bronchitis, respiratory infections.
Chest wall and muscle conditions: chest trauma, rib fractures, spinal cord injuries, myasthenia gravis, muscular dystrophy.
Neurological disorders: stroke, drug overdose, neuromuscular diseases (e.g., ALS).

Risk Factors

Patients with chronic lung diseases (such as COPD, asthma)
Long-term smokers
Elderly individuals or those with weakened immune systems
Obesity (especially severe obesity affecting lung function)
Patients with neuromuscular diseases
History of severe chest injuries or major chest surgery

Diagnosis

Clinical Evaluation	Detailed patient history, observation of breathing patterns, mental status, skin color changes, and clinical symptoms.
Arterial Blood Gas (ABG) Analysis	Testing arterial blood to evaluate oxygen and carbon dioxide levels, determining the type and severity of respiratory failure.
Chest X-ray	To detect pneumonia, fluid accumulation, pneumothorax, or other abnormalities in the lungs.
Pulmonary Function Tests (PFTs)	To assess lung ventilation capacity, particularly useful for chronic cases.
Computed Tomography (CT Scan)	Provides a detailed examination of lung and chest cavity conditions.

Treatment

High-flow Oxygen	A high-flow oxygen nasal cannula provides a slight pressure during a patient's exhalation to help expand the lungs and facilitate the removal of carbon dioxide.
Non-Invasive Ventilation	This technique delivers oxygen and air pressure through a mask or nasal tube to maintain adequate oxygen levels and support breathing without the need for invasive procedures like intubation.

Non-invasive ventilation can assist in reducing the work of breathing and improving oxygen exchange. In addition to non-invasive ventilation, other treatments may include addressing the underlying cause of respiratory failure, providing supplemental oxygen, administering medications to alleviate inflammation or congestion, and ensuring proper fluid balance.