Common Diagnoses

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Respiratory Failure

Respiratory failure is a serious disorder caused by a variety of different medical problems that may or may not start in the lung. Respiratory failure is nearly any condition that affects breathing and ultimately results in failure of the lungs to function properly. The recognition of respiratory failure as a life-threatening problem led to the development of the intensive care unit (ICU) in modern hospitals. ICU personnel and equipment support vital functions to give patients their best chance for recovery.

Conditions that can lead to respiratory failure include congestive heart failure, chronic obstructive lung diseases such as bronchitis, emphysema or asthma, acute respiratory distress syndrome, pneumonia and neuromuscular disease such as Guillain-Barre, myasthenia gravis, or amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease).

Treatment depends upon the underlying cause of the respiratory failure. Patients with acute RF are usually stabilized with a mechanical ventilator to aid breathing. Patients requiring long-term artificial respiratory support may need a tracheostomy.
The prognosis (outlook) for patients with respiratory failure depends mainly upon its cause. In some cases the primary disease causing the RF is irreversible. The best prevention of RF is early treatment of any respiratory disease. 

Acute Respiratory Distress Syndrome (ARDS)

ARDS is the development of sudden shortness of breath within hours to days following an inciting event. These events include trauma, sepsis (infection), drug overdose, transfusion of blood, acute pancreatitis, or aspiration (fluid entering the lungs).

In many cases the cause of the event is obvious, but in others the cause may not be so easy to identify (such as drug overdose). Patients with ARDS are critically ill and may have multisystem organ failure. This is a life-threatening condition requiring hospitalization for prompt treatments.

Death rates have been reported to be in the range of 30%-40%, and increases with advanced age.

Congestive Heart Failure (CHF)

CHF, or heart failure, is a condition in which the heart can’t pump enough blood to the body’s other organs. This can result from coronary artery disease, past heart attack, high blood pressure, heart valve disease, disease of the heart muscle (cardiomyopathy), heart defects present at birth (congenital heart defects), infection of the heart valves and/or heart muscle (endocarditis and/or myocarditis). 

Patients with CHF cannot exert themselves due to shortness of breath. The heart keeps working but not as efficiently as it should. The blood flow out of the heart slows and the blood returning to the heart backs up in the veins causing congestion in the tissues and swelling in the legs, ankles or other parts of the body. When the fluid collects in the lungs it interferes with breathing, especially when the patient is lying down. 

Most people with mild or moderate CHF can be treated. Treatment may include rest, proper diet, modified daily activities, and medication. Various drugs are used to treat CHF and they perform different functions. Once a patient is stabilized a cardiac evaluation is done to determine the underlying cause of the CHF. Long-term management is tailored to the patient’s specific underlying disease. The prognosis (outlook) of CHF depends upon the severity of the cardiac dysfunction. 

Sepsis

Sepsis syndrome is the body’s response to a serious life-threatening infection or inflammation. This is often caused by bacterial infections which get into the systemic blood circulation. Patients may have high fever or abnormally low temperature (hypothermia). They often have a high respiratory rate, low blood pressure, and a fast heart rate. If the blood pressure drops below a critical level or if vital organs receive inadequate oxygen, the condition is called septic shock. 

Patients are treated with aggressive therapy including intravenous fluids, oxygen therapy, medications to stabilize blood pressure and antibiotics to treat the infection causing the response. Surgical drainage of a specific area of infection, such as an abscess, may be needed.