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Respiratory Failure

Respiratory failure occurs when either the pulmonary disease process is so severe or the nerves and muscles that control breathing are so fatigued that the patient is no longer able to adequately breath for his or her self. Processes that can lead to respiratory failure include congestive heart failure, exacerbation of chronic obstructive lung diseases (such as chronic bronchitis, emphysema or asthma), acute respiratory distress syndrome, pneumonia, and neuromuscular disease (such as Guillain-Barré, myasthenia gravis, or amyotrophic lateral sclerosis). Patients with respiratory failure may experience extreme shortness of breath, rapid and shallow breathing patterns, low oxygen blood levels, and retention of carbon dioxide in the blood stream.

Treatment of RF involves stabilization of the patient and therapy directed at the underlying cause of respiratory failure (as described elsewhere). Patients with acute respiratory failure are usually stabilized with some sort of artificial ventilatory assisted device. Patients requiring long-term artificial respiratory support (usually more than one to two weeks in duration) may benefit from a tracheostomy. A tracheostomy is a surgical procedure where a small opening is made in the neck and a tube is placed through this hole into the trachea (windpipe). When the patient recovers from respiratory failure, the tube may be replaced with a smaller tube, and eventually removed. After removal of a tracheostomy tube, the small hole in the neck will gradually close over several weeks. The patient's voice should return normal over this time frame.

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