Respiratory Failure

The bankruptcy of the lungs and respiratory gas exchange in respiratory failure, as needed, can not perform even at rest. Although a further period of respiratory failure Respiratory bankruptcy clinical and pathophysiological concept is difficult to separate these two.

Clinically, respiratory failure, shortness of breath and difficulty breathing authenticating. Respiratory failure of the air entering and leaving the lungs of patients despite all the efforts were unsatisfactory, I can not do a better breathing or air hunger hears laments and closeness. Hypoxemia, respiratory failure, there is only the beginning. PA02 rest is less than 60mm Hg. PaC02 proceed out of the disease on the respiratory acidosis develops in the normal limit of 45 mm Hg. Respiratory failure may be acute or chronic.

Falls below 50 mm Hg in one patient, PA02 birdenibire PaC02 50mm Hg and acute respiratory failure that usually happens if the above. The main cause of respiratory failure in chronic obstructive pulmonary disease. Pathophysiologic abnormality leading to respiratory failure and ventilation abnormalities in these patients usually (alveolar hypoventilation), and ventilation / perfusion deterioration of the balance. Other causes of respiratory failure, restrictive lung disease, cardio-vascular diseases, neuromuscular diseases and respiratory depression.

Chronic obstructive pulmonary disease

Respiratory failure in a patient with chronic obstructive pulmonary disease, whether before explored. This history is important in the diagnosis of the disease. Frequent repetition of the upper respiratory tract infections is important for the diagnosis of chronic obstructive pulmonary disease. In these patients, either gradually or suddenly there is an increasing dyspnea. Exertion Dyspnea initially felt. Later, dyspnea occurs at rest.

On physical examination, additional bronchial tones (sibilan, ronflan Railer) heard in the airway obstruction is indicated. Railer how rough the bronchi of the obstruction, mucus secretion is so large and there are usually so. Can be heard at the end of a maximal expiratory bronchial obstruction under sibilan Railer is indicated, this Railer sometimes sounds better than at the level of the trachea. Of different character in different regions of the lungs of a non-homogeneous ventilation symptom of respiratory sounds heard, frequently observed in chronic obstructive pulmonary disease and a major cause of respiratory failure. The disease can be mild nature of the physical examination, normal findings. Chronic obstructive pulmonary disease and the degree of radiological examination in the diagnosis of the disease would not be very useful. However, radiological signs of emphysema in patients with two or three of the following written finding is important for diagnosis: (1) yassılaşması the diaphragm, (2) retrosternal air district to have a lot of third part, (3) have a lot of 90 degrees and the angle between the sternum and the diaphragm (4) more than presence of cool regions. Furthermore, lung vascular shadows periferies decreases, the heart appears small, the main pulmonary arteries are dilated. In cases of chronic bronchitis, chronic infection in the lungs than the change observed. Chest radiography is an important step in differential diagnosis. For example pnömokonyosis obstructive lung diseases may resemble the clinical symptoms and infections. Different nature, however, the radiographic manifestations.

Lung ventilation and perfusion scintigraphy can be applied in almost every patient without objection. Is an important problem in patients with chronic obstructive pulmonary ventilation and is a useful method for evaluation of abnormalities in perflizyon.

Chronic obstructive pulmonary disease and respiratory failure in lung function tests, especially the 1-day practical assessment seconds, forced vital capacity, diffusion capacity and arterial blood gases (pH, PA02 and PaC02) are evaluated. These patients often repeated blood count and electrocardiography.

Restrictive lung diseases

Lung parenkimasının common diseases and infections, pleural diseases and thoracic deformities, respiratory function, respiratory failure cause by making a restrictive effect.

The main complaints of shortness of breath, restrictive lung disease, as patients feel that closeness. Lungs of air could not say as much as necessary. Tachypnea, and are increasingly severe syanoz. Cough and phlegm is not as important as chronic obstructive pulmonary disease.

On physical examination, breath sounds are coarse or normal. Sometimes spontaneous breathing or coughing after only a thin crepitan Railer widely heard in the lungs.

Chest radiography is widespread infiltration. Restrictive lung diseases, however, the specific nature of change is not radiological. The patient's background, clinical findings and chest radiograph were examined, along with some laboratory tests would be more meaningful. Blood count, electrocardiography is useful in evaluating the prognosis of disease. Biopsy for definitive diagnosis is made if necessary.

Evaluation of lung function tests and degree of restrictive lung abnormality is very useful. This is a useful practical purpose, tests of lung volumes (especially the vital capacity), 1 Seconds, forced vital capacity, minute ventilation, diffusing capacity and arterial blood gases.

Cardiovascular diseases, Cardiovascular Disease

Both obstructive and restrictive lung disease progressively increasing hypoxemia, pulmonary hypertension and right heart hypertrophy causes. In the presence of respiratory failure and lung-heart disease worsens the prognosis further. Furthermore, chronic obstructive or restrictive lung disease with left ventricular failure can be found. a good history, careful clinical examination, chest radiography, ECG, lung function tests and arterial blood gases are useful in evaluating such a possibility. PC02 of arterial blood hypoxemia found an abnormal increase in heart failure in chronic obstructive pulmonary disease usually shows together.

Other factors such as neuromuscular diseases other than lung and heart-vascular abnormalities, respiratory depression, acute anemia, suffocation, burning, oxygen toxicity, myxedema, metabolic abnormalities may lead to respiratory failure.


The earlier the treatment of respiratory failure than success would be so. Better yet respiratory failure patients should be treated for the disease before entering the necessary measures should be taken to proceed. Respiratory failure is the leading cause of chronic obstructive pulmonary disease, restrictive lung disease and other diseases and complications of complying with the characteristics of the disease is treated.

Respiratory failure is the success of hospital treatment provided in a specific intensive respiratory care units-mamışsa patient transported.

Chronic lung disease usually caused by hypoxemia alve-dying hypoventilation and ventilation / perfusion imbalance associated with. Usually depends on the alveolar hipoventilasyona hypercarbia. C02 gas is 20 times more oxygen diffusion to the quality of leads to the development of hypoxemia before hypercarbic. A period of severe chronic obstructive pulmonary disease and respiratory failure developed in all patients with respiratory functions and particularly the increased blood gases should be examined frequently. Intermittent positive pressure breathing (İPBS) is a type of artificial ventilation in intensive care underwent a major. Patient and disease characteristics of cases of respiratory failure indication İPBS depends. İPBS'in main indications in adults:

1. Per minute, respiratory rate of more than 35.
2. Vital capacity 10-15 ml / kg is less.
3. PA02 of breathing pure oxygen nasal catheter is less than 70 mm Hg.
4. Of more than 60mm of Hg PaC02.
5. Clinical symptoms, such as increasing dyspnea and chest X-ray lesions.
6. Despite the decrease of PA02 and PaC02 increase of the required treatment.
The main reason for respiratory failure should be kept in the forefront of treatment of the disease. For example, in the case of status asthmaticus bronchodilator in the treatment of choice, and if necessary, tracheo-bronchial aspirasyondur steroid treatment. Respiratory failure due to left heart failure, pulmonary edema is a result of diuretic treatment of choice here, digital, salt-free regime, and oxygen therapy;

Nutrition in patients with respiratory failure

Of serious digestive disorders is common in patients with chronic obstructive lung and respiratory failure. To do daily activities, especially for chronic obstructive pulmonary ill shall make more calories than normal persons. Disease and increase of calories will vary according to the person özellekliklerine. Body weight is more than can cause lung and heart work harder. The weakening of the patients fat, normal weight, dizziness, an important treatment.

Respiratory failure patients nearly twice as many times the basal metabolic requirements (eg 3000/kalori/gün) should. Indicates that respiratory failure is less than 1200 m3 of total lymphocytes. In these patients, daily protein 0.75-1 gm / kg, dir. And carbohydrate / fat ratio should be 50/50 so many times. Digestive difficulties with less food should be preferred. Food may increase respiratory problems. To prevent this, the need to eat 4-6 meals per day must meet.

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