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Acute respiratory failure


Respiratory failure - a condition in which the respiratory system is not able to provide the flow of oxygen and the excretion of carbon dioxide, necessary to maintain the normal functioning of the body.
Acute respiratory failure is characterized by rapid progression: after a few hours, and sometimes minutes, the patient may die.
The main causes of acute respiratory failure:
─ impaired respiratory tract obstruction when the tongue is collapsed, foreign body obstruction of the larynx or trachea, laryngeal edema, severe laryngism, hematoma or tumor, bronchospasm, chronic obstructive pulmonary disease and bronchial asthma
─ respiratory distress syndrome or “shock lung”, pneumonia, pneumosclerosis, emphysema, atelectasis, thromboembolism of pulmonary artery branches, fat embolism, amniotic fluid embolism, sepsis and anaphylactic shock;
─ some exogenous and endogenous intoxications (opiates, barbiturates), injuries and diseases of the brain and spinal cord, convulsive syndrome of any origin, myasthenia, Guillain-Barre syndrome, etc .;
─ injuries of the chest and abdomen.
DIAGNOSTICS
The main clinical signs of acute respiratory failure: shortness of breath, impaired blood circulation and psychomotor agitation.
The severity of acute respiratory failure is divided into three stages.
Stage I The first symptoms are mental changes. Patients are excited, tense, often complain of headache, insomnia. The frequency of respiratory movements up to 25-30 per minute.
The skin is cold, pale, moist, cyanosis of mucous membranes, nail beds. BP, especially diastolic, increased, noted tachycardia.
Stage II Consciousness confused, motor excitement. The frequency of respiratory movements up to 35-40 per minute. Pronounced cyanosis of the skin, auxiliary muscles take part in breathing. Persistent arterial hypertension (except for cases of pulmonary embolism), tachycardia. Involuntary urination and defecation. With a rapid increase in hypoxia, there may be seizures.
Stage III. Hypoxemic coma. Consciousness is absent. Breathing can be rare and superficial. Cramps. Pupils dilated. Cyanotic skin. Blood pressure is critically reduced, arrhythmias are observed.
URGENT CARE
1. Ensuring airway patency:
= triple reception of Safar (if there is a suspicion of an injury in the cervical spine, you should not unbend your head);
= rehabilitation of the tracheobronchial tree;

= in the presence of a foreign body - its removal under the control of laryngoscopy;
= use of air ducts;
= tracheal intubation or conicotomy.
2. Oxygen therapy. Oxygen inhalation through the nasal cannula, facial mask or intubation tube (with clinical death - 100% oxygen).
3. With chest injuries, pleurisy - pain relief. Elimination of pneumatic and hemothorax.
4. With the ineffectiveness of these measures - transfer the patient to mechanical ventilation.
5. Hospitalization - according to the indications of the underlying disease (see relevant recommendations).
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Acute respiratory failure

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