Respiratory failure
Introduction
Introduction Respiratory failure is a serious disorder of respiratory function, so that normal breathing can not be performed at rest, and hypoxia or carbon dioxide retention occurs, causing a series of clinical and metabolic disorders. In the early stage of illness, only breathing is strong. When it is severe, it is not easy to breathe, sweating is dripping, nails and nails are prominent, mental function changes, directional dysfunction, headache, insomnia, sorrow, irritability, turmoil, and then lethargy, causing coma, convulsions , heart rate is accelerated, blood pressure is elevated, skin vasodilatation and the like. Some severe patients have oliguria, lower extremity edema or liver damage and gastrointestinal bleeding.
Cause
Cause
Respiratory disease
Bronchial inflammation, bronchospasm, foreign body and other obstruction of the airway, causing insufficient ventilation, uneven gas distribution leading to imbalance in ventilation / blood flow, hypoxia and carbon dioxide retention.
2. Lung tissue lesions
Pneumonia, severe tuberculosis, emphysema, diffuse pulmonary fibrosis, adult respiratory distress syndrome (ARDS), etc., can cause lung volume, ventilation, effective diffusion area reduction, ventilation / blood flow imbalance caused by pulmonary artery shunt, caused Hypoxia and/or carbon dioxide retention.
3. Pulmonary vascular disease
Pulmonary vascular embolism, pulmonary infarction, etc., so that part of the venous blood flow into the pulmonary vein, hypoxia occurs.
4. Thoracic lesions
Such as thoracic trauma, surgical trauma, pneumothorax and pleural effusion, etc., affecting thoracic activity and lung expansion, resulting in ventilation to reduce the unevenness of inhalation gas affecting ventilation function.
5. The nerve center and its conduction system respiratory muscle disease
Cerebrovascular disease, encephalitis, brain trauma, drug poisoning, etc. directly or indirectly inhibit the respiratory center, poliomyelitis and muscle neuritis caused by polyneuritis, affecting conduction function, myasthenia gravis and other damage caused by respiratory motility insufficient.
Examine
an examination
Blood gas analysis
At the resting state, the arterial partial pressure of oxygen (PaO2) <8.0Kpa (60mmHg), arterial blood carbon dioxide partial pressure (PaCO2)>6.7Kpa (50mmHg) is type II respiratory failure, and the arterial oxygen partial pressure is reduced to 1 Type of respiratory failure.
2. Electrolyte inspection
Respiratory acidosis combined with metabolic acidosis is often accompanied by hyperkalemia. Respiratory acidosis combined with metabolic alkalosis often has hypokalemia and hypochloremia.
3. Sputum check
The results of examination of sputum smear and bacterial culture are conducive to guiding medication.
4. Other inspections
Such as pulmonary function tests, chest imaging examinations, etc. according to the original disease, there are corresponding findings.
Diagnosis
Differential diagnosis
Difficulty breathing: It is an important symptom of respiratory insufficiency. It is subjectively characterized by insufficient air or difficulty in breathing, and objectively manifested as changes in respiratory frequency, depth, and rhythm.
Sleep apnea: refers to the temporary stop of breathing during sleep. The most common cause is obstruction of the upper airway, often ending with loud snoring, body twitching or arm twitching. Sleep apnea is associated with sleep defects, daytime snoring, fatigue, and bradycardia or arrhythmia and EEG wakefulness.
