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Researching of Acute Respiratory Failure

Introduction

Acute respiratory failure (ARF) occurs when the respiratory system can neither maintain appropriate oxygen levels nor adequately remove carbon dioxide. This condition might affect both healthy patients or those afflicted by chronic pulmonary diseases. In most cases, people with acute respiratory failure require immediate help and additional oxygen. The current paper examines the pathophysiology of acute respiratory failures, discusses the potential methods of treatment, and proposes a plan of care for the affected patients.

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Pathophysiology of Acute Respiratory Failure

Pathophysiology is a study of vital physiological processes which are somehow altered by diseases or mechanical injuries. As mentioned briefly before, acute respiratory failure occurs due to instability in oxygen and carbon dioxide levels. There are two general classifications of acute and chronic respiratory failures, namely, hypoxemic and hypercapnic types (Spinelli et al., 2020). The former refers to the insufficient oxygen in the blood while the carbon dioxide level is close to normal (Spinelli et al., 2020). On the other hand, hypercapnia implies that carbon dioxide is abundant in the blood, and the oxygen level is near normal or not sufficient (Spinelli et al., 2020). The symptoms of acute respiratory failure depend on whether the patient is hypercapnic or hypoxemic.

Consequently, there is a large variety of causes that might lead to acute respiratory failure. The etiologies include both pulmonary and extra-pulmonary pathologies or external factors (Melanson, n.d.). Namely some of them are obstruction of airways, various injuries, infections, mechanical traumas, obesity, hypoventilation, ventilation/perfusion mismatch, and many others (Melanson, n.d.). Frequently, the patients are affected by several causes simultaneously, which might further deteriorate their health condition. A more thorough examination of several prominent etiologies is presented in the following sub-chapters.

Obstruction of Upper Airways

Obstruction occurs when lodged by something in the throat leading to getting adequate oxygen in the lungs. Furthermore, it is widespread in people with chronic obstructive pulmonary diseases (Melanson, n.d.). The airways are made narrow by exacerbation, affecting the average breathing rate. In young children, obstruction increases inspiratory muscle load, decreases alveolar ventilation, and causes hypercapnia and hypoxemia, which have adverse cardiovascular effects.

Injuries

When the respiratory system is injured or impaired, the amount of oxygen in the blood affects the average breathing rate. For example, if the brain or the spinal cord is damaged, it won’t relay messages effectively to the lungs, which affects its proper functioning (Melanson, n.d.). Ribs and chest injuries also hinder the breathing process by impairing the ability to breathe enough oxygen into the lungs. Consequently, various infections and diseases might also negatively impact the health of the patients and cause both hypoxemia and hypercapnia.

Drugs and Excess Alcohol Usage

The excessive use of drugs or alcohol might affect brain functions, which interfere with the ability to inhale or exhale. Additionally, inhaling toxic chemicals, smoke or fumes injures lung tissues such as the air sacs and blood capillaries in the lungs leading to ARF. Inadequate medication, specifically the ones affecting the central nervous system (CNS), might also cause hypoxemic respiratory failure (Melanson, n.d.). Ultimately, there is a large variety of etiologies of acute respiratory failures, and clinicians need to be properly informed about them.

Assessing Patient with Acute Respiratory Failure

Various medical tests are performed to diagnose abnormal sounds in the lungs and heart. They include pulse oximetry, arterial blood gas, and imaging tests. These methods are generally conducted by using medical devices such as stethoscopes, CT scans, and bronchoscopes. The clinician needs to thoroughly examine the patient to determine the health condition and propose a corresponding treatment. Some of the evaluation tests are described in detail below.

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Pulse Oximetry Test

This is a test performed to investigate how well oxygen is being supplied to various body parts. It is conducted by using a small sensor placed at the fingertip to determine whether the supply of oxygen is sufficient. Regular oxygen supply is between 96-100 percent, and anything lower than that indicates low oxygen supply. In other words, the test might reveal decreased oxygen saturation, which is one of the clinical symptoms of acute respiratory failure (Melanson, n.d.). Ultimately, the pulse oximetry test is one of the most reliable and prominent instruments to determine the condition.

Additional Methods

Consequently, an arterial blood gas test might be conducted to determine oxygen and carbon dioxide levels in the bloodstream. The same test also measures the PH and acid content of the blood. Blood is taken from an artery at the wrist and examined and analyzed by a laboratory technician to check out oxygen and carbon dioxide levels in the blood. The abnormal results of this test also indicate the possibility of acute respiratory failure. Imaging tests, such as chest X-rays and computed tomography (CT) scans, might be used to inspect the lung condition. Bronchoscopy is another method to determine the possibility of acute respiratory failure. Clinicians insert a thin-flexible lighted instrument into the airway and lungs to extract lung tissue samples for examination.

Medical Management of Patients with Respiratory Failure

Some of the most prominent methods of medical management of patients affected by acute respiratory failure are inhaled medications and oxygen therapy by using nasal cannulas or mechanical ventilators. These types of treatment are effective for the urgent resuscitation phase (Melanson, n.d.). Inhaled medications are administered through either special devices or nebular machines making the lungs pick up enough oxygen and eliminate carbon dioxide more effectively. In the same manner, bronchodilators are used in the treatment of asthma by opening airways (Cutrera et al., 2017). Consequently, oxygen therapy is an effective way to mitigate life-threatening situations. The treatment is conducted either by using a nasal cannula or a mechanical ventilator. The former is a plastic tube connected to a portable oxygen tank and resting in the nose, allowing the flow of oxygen into the body. A mechanical ventilator is used to blow air into the lungs with a high amount of oxygen. However, prolonged usage of ventilators can damage the lungs and airways.

Plan of Care for Patient with Acute Respiratory Failure

Consequently, it is essential to propose a plan of care for patients affected by acute respiratory failure. The treatment concerns ongoing care after the condition of the patient is stabilized. The primary areas of the plan concern physical therapy, proper nutrition, positioning of the body, and pulmonary rehabilitation programs (Melanson, n.d.). The exercises help maintain the muscles’ strength and prevent sores from forming in the respiratory tissues (Papi et al., 2020). Proper nutrition is necessary for the respiratory organs to ensure a balance between the oxygen required for the body to reduce respiratory failure. Furthermore, lying face down helps to get more oxygen into the lungs reducing the chances of respiratory failure. Pulmonary rehabilitation generally refers to specific programs and breathing techniques to increase oxygen levels. Ultimately, these recommendations constitute the treatment plan of ongoing care for patients affected by acute respiratory failure.

Conclusion

Acute respiratory failure is a severe medical complication that might lead to significant health damage or even lethal outcomes. It is essential to seek professional help as soon as possible to mitigate the potential consequences. Furthermore, it is vital to raise public awareness concerning this medical condition and inform people about the risks. Consequently, clinicians should also undergo essential training to learn about the pathophysiology and possible treatment plans for acute respiratory failures.

References

Cutrera, R., Baraldi, E., Indinnimeo, L., Del Giudice, M. M., Piacentini, G., Scaglione, F., Ullmann, N., Moschino, L., Galdo, F., & Duse, M. (2017). Management of acute respiratory diseases in the pediatric population: the role of oral corticosteroids. Italian journal of pediatrics, 43(1), 1-21. Web.

Melanson, P. (n.d.). Acute respiratory failure. McGill. Web.

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Papi, A., Morandi, L., & Fabbri, L. M. (2020). Prevention of Chronic Obstructive Pulmonary Disease. Clinics in Chest Medicine, 41(3), 453-462.

Spinelli, E., Mauri, T., Beitler, J. R., Pesenti, A., & Brodie, D. (2020). Respiratory drive in the acute respiratory distress syndrome: Pathophysiology, monitoring, and therapeutic interventions. Intensive Care Medicine, 46, 606-618. Web.

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