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Acute respiratory failure



Acute respiratory failure - a violation of gas exchange between ambient air and circulating blood with the presence of hypoxemia and / or hypercapnia, which develops in a period of time from several minutes to several days.

ETIOLOGY AND PATHOGENESIS, CLASSIFICATION

The normal functioning of the respiratory system depends on the work of many of its components (respiratory center, nerves, muscles, chest, respiratory tract and alveoli). Disruption of any of these links can lead to the development of acute respiratory failure.

Pathogenesis acute respiratory failure is divided into:

¦ hypoxic (lack of oxygen) - occurs in case of violation of ventilation-perfusion relations and shunting of blood in the lungs;

¦ hypercapnic (excess carbon dioxide) - develops with the inability of the body to provide adequate ventilation of the lungs;

¦ mixed - violation of both ventilation and perfusion relations, and ventilation function of the lungs.

Dyspnea occurs compensatory, i.e. a change in the frequency, rhythm and depth of breathing, accompanied by an increase in the work of the respiratory muscles and, as a rule, the subjective sensations of lack of air or difficulty in breathing.

Causes of acute respiratory failure

¦ Traumatic and exogenous

? Inhibition of respiratory regulation: head injury; overdose of sedative drugs.

? Neuromuscular lesions: spinal cord injury; drug exposure; intoxication.

? Damage to the chest wall and pleura: rib fractures; scab after burn; thoracoplasty.

? Respiratory tract impairment: foreign body aspiration; hanging.

? Damage to the lungs: contusion; inhalation damage; cytotoxic drugs.

¦ Vascular

? Inhibition of the regulation of respiration: an acute violation of cerebral circulation. ? Neuromuscular lesions: transverse myelitis.

? Damage to the chest wall and pleura: pleural effusion.

? Respiratory lesion: aortic aneurysm.

? Damage to the lungs: PE; acute heart failure; shock; vasculitis.

¦ Oncological

? Respiration regulation depression: primary or metastatic cancer.

? Neuromuscular lesions: paraneoplastic syndromes.

? Damage to the chest wall and pleura: mesothelioma.

? Respiratory trauma: laryngeal cancer; adenoma of the bronchi.

? Damage to the lungs: lymphangitis in cancer; diffuse lymphoma.

¦ Infectious

? Inhibition of respiratory regulation: meningitis; brain abscess; encephalitis.

? Neuromuscular lesions: poliomyelitis; Guillain-Barre syndrome; tetanus; botulism.

? Damage to the chest wall and pleura: empyema.

? Respiratory lesion: COPD.

? Lung damage: pneumonia.

¦ idiomatic

? Inhibition of respiratory regulation: degenerative diseases of the central nervous system.

? Neuromuscular lesions: paralysis of the diaphragm; amyotrophic lateral sclerosis; multiple sclerosis.

? Damage to the chest wall and pleura: spontaneous pneumothorax.

? Respiratory lesion: laryngospasm.

? Lung damage: adult respiratory distress syndrome; fibrosis of the lungs.

¦ Metabolic

? Inhibition of respiratory regulation: coma; myxedema; alkalosis.

? Neuromuscular lesions: hypophosphatemia.

? Damage to the lungs: inhibition of carbonic anhydrase; hypoxemia in liver cirrhosis.

¦ Immunological

? Inhibition of the regulation of respiration: sleep apnea during allergic rhinitis;

? Neuromuscular lesions: myasthenia gravis.

? Damage to the chest wall and pleura: scleroderma; ankylosing spondylitis.

? Respiratory tract impairment: angioedema of the larynx; allergic form of bronchial asthma.

? Damage to the lungs: allergic pneumonitis; transfusion reactions. Complications of acute respiratory failure:

Acute hypoxemia leads to rapid disruption of the functions of vital organs (primarily the central nervous system and the heart);

Acute hypercapnia causes arterial hypotension, electrical instability of the heart, impaired consciousness, to whom.

CLINICAL PICTURE

Complaints and clinical symptoms in acute respiratory failure are not specific and largely depend on the disease that led to its development (Table.
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Acute respiratory failure

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