Our body organs, including the vital ones like heart and brain, need a constant supply of oxygen-rich blood in order to function properly. Respiratory failure is a condition in which a sufficient amount of oxygen does not pass from the lungs into the blood. This condition is also observed when the lungs can’t remove carbon dioxide efficiently from the blood. Too much carbon dioxide in the blood can be harmful to other body organs. Both these respiratory conditions—a low oxygen level and a high carbon dioxide level in the blood—can occur at the same time.
A medical practitioner will examine a patient for respiratory failure on the basis of these parameters:
1. Medical History
The doctor will first want to know whether the patient has or recently had any diseases or conditions that could lead to respiratory failure. These could be disorders relating to the lung, muscles, nerves, bones or tissues or even spinal injuries that can affect the normal functioning of the respiratory system.
2. Physical Exam
The doctor will next conduct a physical exam to detect signs of respiratory failure and its underlying cause. Using a stethoscope, they will listen to the patient’s lungs for abnormal sounds and then heart for signs of irregular heartbeat. They may also check the patient’s skin, lips, and fingernails for a bluish colour as it indicates low oxygen level in blood. As respiratory failure also causes extreme sleepiness and confusion, so the doctor might also check how alert the patient is.
3. Diagnostic Tests
To find out the oxygen and carbon dioxide levels in the blood, the patient may be prescribed the pulse oximetry and arterial blood gas test. They may also be asked to get other tests, such as a chest X-ray, to help find the underlying cause of respiratory failure.
Treatment and Management
The course of treatment to be adopted for respiratory failure depends on whether the condition is acute or chronic and on the basis of its severity. Treatment also depends on the underlying cause of the condition.
Acute respiratory failure is considered a medical emergency. So this condition is treated in an intensive care unit at the hospital. On the other hand, chronic respiratory failure can be treated at home. If chronic respiratory failure is severe, treatment is recommended in a long-term care centre.
One of the primary goals of treating respiratory failure is to get oxygen into the patient’s lungs and other organs and remove carbon dioxide from the body. The other goal is to treat the underlying cause of the condition.
To get oxygen into the patient’s lungs, they may be treated with oxygen therapy. In this, extra oxygen is given through nasal tubes or aventuri mask that fits over the patient’s nose and mouth. Oxygen can also be given through a tracheostomy. In this, a breathing tube is placed in a surgically made hole that goes through the front of the neck and into the windpipe to help the patient breathe.
If the oxygen level in blood does not increase to the optimum level, or if the patient still experiences trouble breathing, the doctor may recommend a ventilator. A ventilator is a machine that supports breathing by blowing air—or air with increased amounts of oxygen—into the patient’s airways and then, lungs. This will help the lungs get the right amount of oxygen. The ventilator will be applied until the patient can breathe on their own.
Other Treatments To Assist Breathing
Noninvasive positive pressure ventilation (NPPV) and a rocking bed are two other methods that can help a patient, especially if they suffer from chronic respiratory failure.
NPPV is a treatment that involves mild air pressure to keep the airways open while the patient is sleeping. For this, the patient has to wear a mask or other device fitting over the nose and mouth. The mask is connected to a machine, which blows air through a tube.
A rocking bed consists of a mattress that rocks gently back and forth. When the patient’s head rocks down, the organs in their abdomen and diaphragm slide up and help to exhale. When the head rocks up, those organs slide down, helping the patient inhale.
If the doctor thinks medication can solve the problem, they may prescribe medicines to relieve discomfort caused by respiratory failure.