respiratory distress vs respiraotry failure

yatyu · Feb 20, 2007

anyone help???

**canoehead, BSN, RN** · Feb 20, 2007

I don't know if there is an official definition...but I define it as distress- having a problem respiratory wise vrs failure- measurably getting worse with time.

You can be in distress with a cough/cold, but stable and not be getting worse. Resp failure that is allowed to continue will eventually lead to death and is a more serious condition.

neneRN, BSN, RN · Feb 20, 2007

Respiratory distress can be further broken down to mild, moderate, or severe respiratory distress. With mild resp distress, you may see minimal SOB, cough, slight wheezes, upper airway congestion. Moderate would involve more obvious SOB, tachypnea, abnormal breath sounds, use of accessory muscles, or pursed lip breathing. Severe resp distress would be obviously labored resps, severe tachypnea, poor color, fatigue/weakness from effort of breathing, audible wheezing/rales/rhonchi--needs immediate intervention or will progress to respiratory failure. Respiratory failure is when pt becomes apneic, requires mechanical ventilation, or is refractory to all attempted medical treatments to improve breathing. (This is just my own way of classifying, not from a textbook)

yatyu · Feb 23, 2007

So will pt become bradypnea before apneic in respiratory failure case????

yatyu · Feb 25, 2007

so what is respiratory distress syndrome??? is it same as respiratory distress???

kicklpn · Apr 3, 2011

The job of the lung is too excrete CO2 and intakes O2. in respiratory distress, the gas exchange is altered due to some type of lung infection or fluid in alveoli which blocks O2/CO2 exchange. With respiratory failure, gas exchange altered or lung function deteriorate due to either brain control to the lung is affected or it could be due to an unknown cause which causes the lung failure to work properly.

tewdles, RN · Apr 3, 2011

Respiratory distress is a symptom. It implies pathology.

A person can experience respiratory distress for a mechanical reason...pneumothorax, chest trauma, or aspiration of foreign object might be examples.

There are also physiologic reasons for distress such as infection.

Respiratory failure describes a medical condition which requires ongoing intervention to minimize the symptoms and progress of the disease. That failure may be precipitated by a variety of things. We can experience chronic respiratory failure (COPD might be an example) or acute failure (drowning or ARDS would fall into this category) and part of our symptom burden would be varying degrees of respiratory distress.

We can often treat distress with morphine, bronchodilators, oxygen, etc., and achieve some improvement of the symptoms. Sometimes acute distress will require mechanical support.

A patient that is suffering from respiratory failure will have some distress. A patient that is suffering from respiratory distress may not have respiratory failure per se.

This is not a text book answer, just a simplified summary of my understanding...so accept it for what it is worth.

RN1980 · Apr 21, 2011

there are many text book answers that will show the classroom difference between them. but for practical preference...i consider it resp failure when they are on non-rebreather at flush and their resp drive vigor has not improved along with continued facial pallor, they are becomming less responsive to direct simple questions, they are now taking gulps of air..obviously they will becomming bradycardic "late sign". better crack the airway cart.

dmc_rrt · May 2, 2011

Simply put: Resp distress, which is increased WOB, will lead to resp failure when the muscles can no longer do the work. similar to untrained legs trying to run a marathon.

ARDS is filling of the alveoli with protiens leading to poor lung compliance. the muscles have to work harder to ventilate. This will lead to resp failure.

kdavis308 · Sep 15, 2012

Im actually surprised by the number of people having trouble answering this question.

Respiratory Distress: Is a symptom they are experiencing. The patient is short of breath. (dypsneic). It also involves the psychological aspect of dyspnea.

Respiratory Failure: Inadequate gas exchange at the alveolar level. There are two types.

Hypoxic (Type 1) which means on a blood gas or pulse oximeter the SaO2/PaO2 or SpO2 if Pulse Ox are decreased.

Hypercapneic (Type 2) means the patient is unable to adequately eliminate CO2. On a blood gas the patient would have an elevated PaCO2 or with Capnography and elevated EtCO2.

Treatment for respiratory failure should always involve increasing the airway pressure either by intubation with mechanical ventilation or non-invasively with either CPAP for hypoxic failure or CPAP with PS (BiPAP) for Hypercapneic failure. If the patient has a significant shunt (meaning obstruction of lower airways not allowing oxygen to get to the functional levels of the lung) then increasing the FiO2 or percentage of O2 will not help.

CPAP is often times adequate for hypoxic failure as one provides extra pressure expanding the alveoli thus increasing surface area and oxygenation. CPAP will not substantially help hypercapneic failure as it does not increase tidal volumes.

BiPAP or CPAP with Pressure Support will likely be beneficial for Hypercapneic failure because the pressure is ramped up when the patient takes a breath improving tidal volumes thus allowing the patient to blow off more CO2.

anon456, BSN, RN · Oct 5, 2012

You've had several good answers . .

I work on a peds pulmonary floor. We get some RSV babies that are admitted for resp distress, meaning they are having retractions, increased WOB, breathing too fast to be allowed to eat (hard to suck and swallow if you can't breathe well). If they continue having respirations above 60, are showing nasal flaring, head bobbing, retractions and looking just plain tired, they are watched very very carefully because they are in danger of pooping out. Many are intubated at this point because of impending respiratory failure. They will get acidotic as shown by a blood gas and if it is allowed to go past this point they are in danger of coding. There is a good reason why our unit shares space with the PICU . . . in case of intubation.