Degrees of DN. Classification of respiratory failure by severity

Respiratory failure often occurs in people with various lung diseases. With bronchitis, pneumonia, asthma, chronic obstructive pulmonary disease, a lack of oxygen can be observed, which leads to tissue hypoxia throughout the body. Respiratory is not important enough to notice and compensate in time, otherwise irreversible changes may begin in the patient's body. You can read more about the degree of DN, classification and treatment methods in this article.

What is respiratory failure?

Normally, the gas composition of the blood is a combination of carbon dioxide and oxygen. The norm for carbon dioxide is about 45%, this percentage allows you to activate the respiratory center and control the depth and frequency of inspiration and exhalation. The role of oxygen is also understandable: it saturates the entire body, getting into the bloodstream and transmitted to cells through a connection with hemoglobin. Respiratory failure manifests itself in a change in the gas composition of the blood. The inability of the body to provide the proper flow of oxygen at first can be compensated by other body systems. But with such a load, the human body is very quickly depleted, and DN is manifested more clearly. That is why doctors are strongly advised to pay attention to their well-being and take all tests on time.

The human respiratory system is closely related to the circulatory system. Violations of one of the functions are compensated by the increased work of the other. For example, if the patient becomes hard to breathe, the heart begins to beat more often in order to have time to saturate all the tissues with oxygen. If this measure does not help, and hypoxia increases, then the body begins to increase the production of red blood cells and hemoglobin. If this continues for a long time, then the body's abilities decrease, and it becomes unable to maintain normal blood gas exchange.

Causes of Nam

Respiratory failure syndrome is most often observed in preschool children and the elderly. This is due to the fact that their lungs can not cope with the burden placed on them, and even a simple SARS can worsen the condition. What other causes of respiratory failure exist?

• Congenital and acquired pathologies of the central nervous system. Our breathing is the most complex mechanism that is regulated by the respiratory center of the medulla oblongata. This is one of the most ancient systems of our body, but it can also be disturbed as a result of head injuries or congenital pathologies of the central nervous system.
• Narcotic and alcohol intoxication can be harmful, in severe cases, the patient continues to live only in conditions of mechanical ventilation.
• Prematurity. If the baby is born too early, the respiratory center does not have time to form, so DN develops.
• Infections affecting the nervous system (botulism, meningitis).
• Diseases of the lungs (pneumonia, bronchitis, COPD).
• Increased blood pressure in the pulmonary vessels.
• The formation of pathological connective tissue in the lungs.
• Severe stages of spinal curvature can significantly affect chest volume, causing chronic respiratory failure.
• Abscess of the lung.
• Heart defects (an unclosed oval window, etc.).
• Low hemoglobin.
• Imbalance of thyroid hormones.
• Rare genetic diseases (SMA).
• Structural changes in the lungs due to smoking or damage by aggressive gases.

Respiratory failure develops in various pathological conditions, often the cause may be a banal lack of physical activity and weak muscle tone. But, despite the huge list of prerequisites, NAM can be prevented by timely prevention.

Classification

The severity of changes in the gas composition of the blood depends on the severity of respiratory failure. Specialists distinguish four stages of the disease:

• Respiratory failure of the 1st degree begins with a difficult breath. A person has to exert more effort for breathing, pectoral muscles are connected to work. At this stage, the patient already begins to sink a triangle between the ribs in front of the chest. Young children begin to behave uneasily. Breasts often cry, they may experience intermittent cyanosis, which improves during oxygen breathing. At night, the patient’s condition usually worsens, as the activity of the respiratory center decreases.
• DN 2 degrees can be easily recognized by noisy breathing, which is heard even at a distance of several meters from the patient. Due to the efforts that the body has to exert for breathing, the patient sweats a lot and experiences general muscle weakness. The symptoms are joined by cough, pallor of the skin, altered voice.
• Respiratory failure of the third degree - this is the penultimate stage of the disease, in which the patient can only be in the hospital. The patient has pronounced shortness of breath with severe retraction of the chest. All the forces of the body rush to maintain respiratory function, so a person is passive and apathetic. Changes occur in the circulatory system: the heart suffers, the drop in blood pressure and tachycardia begin.
• Day 4 of the degree is a fatal degree of the disease. It is practically untreatable. Often at this stage, respiratory arrest is observed. As a result, the patient develops encephalopathy, convulsions, coma.

Respiratory failure of the 1st degree is the most easily treatable stage of the disease. In this period, you can still prevent many changes in the body, which then cannot be reversed.

Classification of respiratory failure

Respiratory failure has not only different degrees of severity, but also a different classification. Depending on the cause of the disease, the following types of DN are distinguished:

• Obstructive - characterized by blockage of the alveoli in the bronchi by various foreign bodies. It can be either foreign bodies (for example, small objects), or mucus and pus. For example, with bronchitis and pneumonia, the alveoli are clogged with viscous sputum, which reduces the effective amount of respiration and as a result leads to DN. Fortunately, this type of disease is easily reversible, it is enough just to take timely measures to cure the underlying disease.
• Hemodynamic DN occurs in case of circulatory disorders of the lung site. As a result, the necessary amount of oxygen ceases to flow into the blood.
• The diffuse type of respiratory failure is also called respiratory distress syndrome. The reason for its formation is the thickening of the septum between the alveoli and the blood vessel. As a result, oxygen does not enter the bloodstream, and the body lacks this gas. In children, this type of DN occurs due to prematurity and immaturity of the alveoli.
• A restrictive degree of DN appears due to structural changes in the lung tissue, which loses its elasticity and begins to perform its function worse. Restrictive DN is formed with pneumothorax, pleurisy, kyphoscoliosis.

Acute and chronic DN

The organs of the chest are closely interconnected. Respiratory failure can develop for several years before a person understands what is the matter and takes action. Depending on the severity, two degrees of DN are distinguished:

• Sharp.
• Chronic

Acute respiratory failure begins suddenly and develops very quickly. Literally in a matter of minutes, the patient's condition can noticeably worsen. Small children who have undeveloped lungs are especially at risk of developing acute NAM. The acute period of the disease cannot be confused with anything: vital signs rapidly deteriorating, a person turns pale, breathing becomes difficult. Often the cause of acute respiratory failure is a variety of injuries or poisoning with chemicals that disrupt gas exchange in the body. If you do not provide emergency medical assistance to the victim, encephalopathy, coma, or death may occur.

The chronic degree of DN develops for more than one year. At first, the patient may not even pay attention to the initial signs of the disease. However, over time, the patient's condition worsens. It is important, at the very first deviations, to identify the DN, establish its cause and cure it. If this is not possible, then it is necessary to help the body with maintenance therapy in order to prevent further deterioration.

How to determine the degree of DN yourself?

It is important for every person to know the first symptoms of respiratory failure in order to recognize the disease in time. What are the signs to determine the DN?

Anxiety should be shown already when you notice the first alarming “bells”. In children, this can be anxiety and crying, previously unusual for them, and in adults - shortness of breath and a slight deterioration in general condition. At this stage, you need to contact a specialist or at least take a blood test to monitor the situation. But it must be remembered that at the initial stage, the body compensates for respiratory failure, so only a specialist can determine it. The first degree of DN has a striking symptom: cyanosis of the nasolabial triangle, which 100% indicates a lack of oxygen in the blood. If all the skin acquires a pale blue tint, then this already speaks of the second stage of DN. “Marbling” occurs in the third or fourth degree of respiratory failure. Translucent veins and blood vessels under the skin clearly indicate that the patient needs hospitalization and urgent medical care.

Diagnostics

The causes and treatment of shortness of breath should begin to be sought immediately after you begin to notice such changes. The following methods are used to diagnose respiratory failure:

• Collection of medical history. The doctor carefully examines the patient’s medical history, his complaints, learns his lifestyle.
• External examination of the patient. With the help of a study of the skin, pectoral muscles, heart rhythm, the doctor can confirm or refute his guesses.
• Analysis of the gas composition of the blood is a reliable study. In the presence of abnormalities, a disease of the chest organs can be assumed.

The doctor makes the final diagnosis after a comprehensive diagnosis. It must be confirmed by laboratory tests.

Treatment and first aid

The treatment of respiratory failure can be divided into two types: emergency care, as well as diagnostic and symptomatic treatment of the disease. Emergency care is provided in acute DN, when the patient's condition worsens literally before our eyes. Before the ambulance arrives, you must perform the following sequence of actions:

1. Lay the patient on the right side.
2. Untie a tie, neckerchief, top buttons of a blouse or shirt in order to ensure the flow of oxygen.
3. Remove foreign bodies or sputum from the throat with gauze (if necessary).
4. If respiratory arrest occurs, begin resuscitation. For example, artificial respiration and heart massage.

If we are talking about a chronic condition, then for the treatment of respiratory failure it is necessary, first of all, to identify the causes of its occurrence. For this, various laboratory and diagnostic tests are carried out. The main treatment groups can be distinguished:

• Oxygen therapy or oxygen treatment. Even with small respiratory failure, doctors resort to this method in order to avoid hypoxia in the tissues and support the body. This method of treatment instantly improves the current condition of the patient, but, unfortunately, does not solve long-term problems.
• Antibacterial allows you to cure obstructive type of BP, as it affects the bacteria and microorganisms that caused respiratory disease.
• Hormonal drugs like Pulmicort and Prednisone help eliminate pulmonary edema and ease breathing. In chronic respiratory diseases, these drugs are prescribed as maintenance therapy.
• Bronchodilators and anti-inflammatory drugs (Berodual, Salbutomol) are prescribed to eliminate obstruction. They begin to act in a few hours.
• Mucolytic agents ("Lazolvan", "Ambroxol") are prescribed in case of dry cough and "congestive" sputum.
• In the case of a severe course of the disease with abundant sputum separation, drainage massage and sanitation of the upper respiratory tract are prescribed to prevent pneumonia.
• Respiratory gymnastics can significantly improve the patient's condition if it is carried out in a timely manner and regularly.

Prevention and prognosis

Any disease is easier to prevent than to cure. This is also true for respiratory failure. With complaints of shortness of breath during exercise, it is important to immediately start preventative measures:

• Timely and adequate treatment of diseases.
• Control of the gas composition of the blood.
• Moderate physical activity.
• Breathing exercises.
• Annual medical examination.

Complications

Here are some complications respiratory failure can lead to:

• On the part of the heart and blood vessels. Respiratory failure increases the load on the cardiovascular system, causing specific diseases such as ischemia, hypotension, heart attack, etc.
• The digestive organs (intestines, stomach) are also at risk from respiratory failure. With this disease, you can get a stomach ulcer, intestinal bleeding and irregular stool.
• Most clearly, DN affects the brain and other organs of the central nervous system. The patient becomes irritable, lethargic, unable to concentrate.
• Quite often, respiratory failure leads to inflammatory processes in the lungs (pneumonia, bronchitis).

As you can see, there are many causes of shortness of breath. Treatment should be started immediately, as you notice in your body the alarming syndromes. Perhaps it’s all because of the hot weather or your tiredness. But respiratory failure syndrome is a serious disease that, if not properly treated, can cause the patient to die. Therefore, it is important to diagnose acute and chronic DN in time and start treatment immediately.