Respiratory insufficiency

Respiratory insufficiency is a condition of an organism of pathological character during which the system of external respiration does not provide normal gas composition of blood or it is reached only during the increased breath work (asthma).

It is possible to diagnose this disease on the reduced partial pressure of oxygen of 45 mm of mercury.

Classifications of respiratory insufficiency

Classifications of this disease exists a little.

1. Classification by a patogenetika.

• Ventilating;
• Parenchymatous.

Ventilating is characterized by a hypercapnia and an anoxemia (the anoxemia can easily be cured by means of oxygen therapy). Are the reasons of emergence:

• weakness or exhaustion of the muscles which are responsible for breath;
• mechanical defect of a muscular and bone framework of a thorax;
• dysfunction of the center which is responsible for breath.
• kyphoscoliosis;
• big weight;
• damage of the muscles which are responsible for respiratory function;
• HOBL.

During a parenchymatous form the hypoxia which korrigirutsya hard by an oxygen therapy is observed. There is this classification because of:

• pneumonia;
• cardiogenic fluid lungs;
• RDSV.

2. Classification by development speed.

• chronic respiratory insufficiency;
• acute respiratory insufficiency.

The chronic form can develop gradually and imperceptibly several months or years, and also after incomplete recovery at an acute form.

Acute respiratory insufficiency can develop in several minutes, hours or days, is life-threatening and practically in all cases develops together with hemodynamic disturbances. It can also develop if the person already has a chronic form (because of an aggravation or a decompensation of a chronic form of respiratory insufficiency).

3. Classification after severity.

Distinguish three degrees of respiratory insufficiency on weight of course.

At the first degree (insignificant) sometimes there is asthma, pulse at rest makes about 80 beats per minute and cyanosis is absent or is insignificant.

At the second degree (moderate) an asthma arises even during usual loadings, pulse is inclined to increase, and cyanosis – clear or considerable.

During the third degree of the respiratory insufficiency (expressed) an asthma is observed even in a quiet state, pulse is speeded strongly up, and cyanosis diffusion, sharply expressed.

Acute management at acute respiratory insufficiency

Acute management at acute respiratory insufficiency consists in recovery and maintenance of free passability and drainage of respiratory tracts, elimination of the accompanying deviations in blood circulation, improvement of gas exchange in lungs and alveolar ventilation.

To provide free passability in respiratory tracts, first of all it is necessary to put the patient in the correct situation. Often disturbances of passability in a drink are caused by retraction in a language hypopharynx. In a throat, a trachea and bronchial tubes impassability can cause hit of third-party bodies, accumulation of a pathological secret, hypostasis or a spasm, and also squeezing of respiratory tracts because of a mechanical injury or a tumor. The first that needs to be made, is to lay the victim on the right side.

For the prevention and elimination of sticking of language the mandible is removed forward and, at the same time, in an occipital and cervical joint make overextension. That to make it, it is necessary to shift by means of pressure thumbs a mandible down, and the fingers further located to push in jaw corners it forward, at the same time reunbending the head back. These manipulations will help to recover quickly passability in a drink.

Sticking of language is also prevented by means of special oral air ducts. Before their introduction the stomatopharynx is cleared gauze napkins or suck away a secret an aspirator.

Also it is possible to give acute management by means of an intubation of a trachea, a konikotomiya or tracheotomy.

Treatment of respiratory insufficiency

Treatment of respiratory insufficiency combined. For a start it is necessary to define a look and degree of respiratory insufficiency and that, how fast it develops. It is necessary to treat both insufficiency, and the reason which brings to it.

Generally apply oxygen therapy to treatment of respiratory insufficiency. When breath and gas composition of blood do not improve, carry out noninvasive assisted ventilation by two-level positive pressure. If and it does not help, use of invasive artificial ventilation of the lungs is recommended. It is necessary to carry out treatment to the same time and a basic disease by means of antibiotic therapy. It is necessary to ventilate lungs before full recovery of good independent breath.

Respiratory insufficiency at children

The reasons of respiratory insufficiency at children much. There is it at children because of respiratory diseases, disturbances of passability of respiratory tracts after regurgitation or vomiting, a parenchyma of a lung, retraction of language, injuries or diseases of the central nervous system, muscular dystrophies, a myasthenia, and also after hit of third-party bodies or an injury of a thorax.

It is possible to reveal respiratory insufficiency at the child on an anoxemia, hyper - and hypocapnies. It should be noted that the hypercapnia does not develop without anoxemia – they are combined.

Hospitalization at the third degree of respiratory insufficiency is obligatory.