What does shallow breathing mean? Measurement of control and maximum pauses

An adequate breathing rate for an adult, provided it is determined at rest, ranges from 8 to 16 breaths per minute. It is normal for an infant to take up to 44 breaths per minute.

Causes

Frequent shallow breathing occurs due to the following reasons:

Symptoms of breathing problems

Forms of respiratory disorders that are manifested by shallow breathing

• Cheyne-Stokes breathing.
• Hyperventilation is neurogenic.
• Tachypnea.
• Biota respiration.

Central hyperventilation

It is deep (shallow) and frequent breathing (RR reaches 25-60 movements per minute). Often accompanies damage to the midbrain (located between the hemispheres of the brain and its stem).

Cheyne-Stokes breathing

A pathological form of breathing, characterized by deepening and increasing respiratory movements, and then their transition to more superficial and rarer ones and, at the end, the appearance of a pause, after which the cycle repeats again.

Such changes in breathing occur due to an excess carbon dioxide in the blood, which causes disruption respiratory center. In young children, such changes in breathing are observed quite often and disappear with age.

In adult patients, shallow Cheyne-Stokes breathing develops due to:

Tachypnea

Refers to one of the types of shortness of breath. Breathing in this case is shallow, but its rhythm is not changed. Due to the superficiality of respiratory movements, insufficient ventilation of the lungs develops, sometimes lasting for several days. Most often, such shallow breathing occurs in healthy patients for severe physical activity or nervous overstrain. Disappears without a trace when the above factors are eliminated and is transformed into normal rhythm. Occasionally develops against the background of certain pathologies.

Biota breath

Synonym: ataxic breathing. This violation characterized by disordered breathing movements. Wherein deep breaths turns into shallow breathing, intermittent complete absence breathing movements. Atactic breathing accompanies damage to the posterior part of the brainstem.

Diagnostics

If the patient has any changes in the frequency/depth of breathing, you will need to urgently consult a doctor, especially if such changes are combined with:

• hyperthermia (high temperature);
• nagging or other pain in the chest when inhaling/exhaling;
• difficulty breathing;
• new tachypnea;
• grayish or bluish tint to the skin, lips, nails, periorbital area, gums.

To diagnose pathologies that cause shallow breathing, the doctor conducts a number of studies:

1. Collection of medical history and complaints:

• duration and features of the onset of the symptom (for example, weak shallow breathing);
• preceding the appearance of violations of any significant event: poisoning, injury;
• the rate of manifestation of breathing disorders in the event of loss of consciousness.

2. Inspection:

3. Blood test (general and biochemistry), in particular, determination of creatinine and urea levels, as well as oxygen saturation.

11. Scanning the lungs for changes in ventilation and perfusion of the organ.

Treatment

The primary goal of shallow breathing therapy is to eliminate the main cause that caused the appearance of this condition:

Complications

Shallow breathing in itself does not cause any serious complications, but can lead to hypoxia (oxygen starvation) due to changes respiratory rhythm. That is, superficial breathing movements are unproductive because they do not provide proper oxygen supply to the body.

Shallow breathing in a child

Normal breathing rate is different for children of different ages. So, newborns take up to 50 breaths per minute, children up to one year old - 25-40, up to 3 years old - 25 (up to 30), 4-6 years old - up to 25 breaths under normal conditions.

If a child 1-3 years old performs more than 35 breathing movements, and a child 4-6 years old - more than 30 per minute, then such breathing can be regarded as shallow and frequent. At the same time, it penetrates into the lungs an insufficient amount air and the bulk of it is retained in the bronchi and trachea, which do not take part in gas exchange. For normal ventilation, such respiratory movements are clearly not enough.

Consequently similar condition, children often suffer from acute respiratory viral infections and acute respiratory infections. In addition, superficial rapid breathing leads to the development of bronchial asthma or asthmatic bronchitis. Therefore, parents should definitely consult a doctor to find out the reason for the change in the frequency/depth of breathing in the baby.

In addition to diseases, such changes in breathing can be a consequence of physical inactivity, overweight, habits slouch, increased gas formation, poor posture, lack of walking, hardening and sports.

In addition, shallow rapid breathing in children can develop due to prematurity (lack of surfactant), hyperthermia ( high temperature) or stressful situations.

Rapid shallow breathing most often develops in children with the following pathologies:

• bronchial asthma;
• pneumonia;
• allergies;
• pleurisy;
• rhinitis;
• laryngitis;
• tuberculosis;
• chronic bronchitis;
• heart pathologies.

Therapy for shallow breathing, as in adult patients, is aimed at eliminating the reasons that caused it. In any case, the baby must be shown to a doctor to make a correct diagnosis and prescribe adequate treatment.

You may need to consult the following specialists:

• pediatrician;
• pulmonologist;
• psychiatrist;
• allergist;
• pediatric cardiologist.

A feeling of lack of air is one of the most common symptoms of vegetative-vascular dystonia and panic disorder. VSD with respiratory syndrome capable of causing fear, but does not in itself lead to disability or fatal outcome. In this article we will try to figure out why I am “choking” or “can’t take a full breath” - common complaint people with VSD, and also consider the cause of breathing problems.

Hyperventilation syndrome - what is it?

Hyperventilation syndrome is one of the forms autonomic disorder, the main symptom of which is difficulty breathing. Moreover, this disorder is in no way associated with diseases of the heart, bronchi and lungs

Literally, hyperventilation syndrome means excessive breathing. Today, shortness of breath syndrome is considered one of the common symptoms of autonomic dysfunction. nervous system(other symptoms may be present at the same time).

Causes of hyperventilation with a feeling of lack of air

Breathing is such a function in human body, which is under the control of not only the autonomic, but also the somatic nervous system. In other words, emotional condition human health directly depends on the functioning of the respiratory system and vice versa. Stressful state, depression or just temporary life difficulties can lead to shortness of breath and a feeling of lack of oxygen.

Sometimes the cause of respiratory attacks accompanying VSD can be an unconscious tendency of people to imitate the signs of certain diseases ( we're talking about about suggestibility - symptoms, for example, “I can’t take a deep breath,” are picked up by a person after surfing the Internet and studying forums) and its further manifestation in everyday behavior (for example, coughing and shortness of breath).

There is also a seemingly unlikely reason for the development of breathing difficulties during adult life: observation in childhood of people with shortness of breath (patients with bronchial asthma, etc.). Human memory is capable of “fixing” certain events and memories and reproducing them in the future, even years later. As a rule, for this reason, breathing difficulties are observed in artistic and impressionable people.

As you can see, in each of the described cases, the psychological component of the occurrence of breathing problems with NCD comes first. Those. Once again we see that we are talking about neurosis.

Breathing disorders due to VSD: mechanism of development

Being in stressful situation, in a state of fear, overwork or anxiety, a person can unconsciously change the depth of breathing and its rhythm. Trying to provide the muscles with an additional flow of oxygen, a person, as if in front of sports competitions, trying to breathe faster. Breathing becomes frequent and shallow, but additional oxygen remains unclaimed. This leads to subsequent unpleasant and frightening sensations of lack of air in the lungs.

Moreover, the occurrence of such disorders leads to a state constant anxiety and fear, which ultimately contributes to the emergence panic attacks, which aggravate the course of the already “difficult” hyperventilation syndrome.

Changes in the blood. Improper breathing leads to changes in blood acidity: frequent shallow breaths lead to a decrease in carbon dioxide levels in the body. A normal concentration of CO2 in the body is necessary to maintain the walls of blood vessels in a relaxed state. Lack of carbon dioxide leads to muscle tension, vasoconstriction - the brain and body begin to experience oxygen deficiency.

Cardiovascular disorders. Frequent shallow breathing leads to changes in the amount of minerals such as calcium and magnesium in the blood, which causes discomfort or pain in the heart area, chest pressure, dizziness, trembling of limbs, etc.

Symptoms of hyperventilation syndrome

The symptoms of breathing problems are varied, and in any given case, the breathing problem manifests itself in different ways. Breathing pathology may be accompanied by muscle, emotional disorders, A typical symptoms hyperventilation syndrome is often “masked” as signs of heart, lung and thyroid gland(angina pectoris, bronchitis, goiter, asthma).

Important! Breathing disorders with VSD are not at all associated with diseases internal organs and their systems! However, a direct connection has been traced and proven between hyperventilation syndrome, nervous disorders and panic attacks.

One way to reduce the feeling of shortness of breath when attack of VSD- breathe into a paper bag

This one is exclusively psychological problem may be manifested by the following symptoms:

• Feeling of lack of air, “incomplete” or “shallow” inspiration
• Feeling of tightness in the chest
• Yawning, cough
• "Lump in throat", difficulty breathing
• Heartache
• Numb fingers
• Fear of stuffy and cramped spaces
• Fear of death
• Feelings of fear and anxiety, tension
• Dry cough, wheezing, sore throat

Important! In the presence of asthma, patients find it difficult to breathe when exhaling, and with hyperventilation, problems arise when inhaling.

In people with VSD symptoms respiratory disorder may be the main complaint, or may be mild or even absent.

What are the dangers of breathing problems with VSD?

The feeling of lack of air during VSD and neuroses is an unpleasant symptom, but not so dangerous. And treat unpleasant symptom It is necessary as a way for the body to communicate that it is difficult for it to cope with stress or overwork.

However, the difficulty of diagnosing this imbalance in the functioning of the autonomic nervous system can lead to a false diagnosis and, accordingly, to the prescription of incorrect (even dangerous!) treatment.

Timely assistance with hyperventilation syndrome very important: otherwise, problems with cerebral circulation and the proper functioning of the digestive and cardiovascular systems may occur.

Also, a difficulty on the path to recovery can be a person’s reluctance to admit that he has hyperventilation syndrome: he stubbornly continues to “attribute” to himself more serious problems with health. It is very difficult to get rid of breathing problems in such a situation.

Psychology for treating the feeling of lack of air during VSD

Providing a person with intelligible information about changes in the state of his body, teaching self-control during exacerbations, changing a person’s attitude towards his illness - these are just some aspects of psychotherapeutic treatment.

Pathological physiology of breathing.

1. The respiratory organs carry out gas exchange between the body and external environment, are involved in regulating water metabolism, maintaining a constant body temperature and are an important factor in the blood buffer system.

Breathing is carried out by the lungs and respiratory muscles, brain, circulatory organs, blood, glands internal secretion and metabolism.

Breathing is distinguished: external- exchange of gases between the blood and the external environment;

internal- exchange of gases between blood and cells.

The breathing centers are located in medulla oblongata, cerebral cortex, hypothalamus and spinal cord (regulates the activity of the respiratory muscles). The vagus also influences breathing (it ensures its automaticity).

Reflexively, breathing increases with low blood pressure, increased CO 2 levels in the blood, and increased blood pH

decreases with an increase in blood pressure, a decrease in the CO 2 content in the blood, a decreased blood pH, with intoxication, the effect of sleeping pills, Co 2 (carbon monoxide), with anemia, etc.

2. Insufficient external respiration.

The effectiveness of external respiration depends on the relationship between three main processes: ventilation of the alveoli, diffusion of gases across the alveolar-capillary membrane, and lung perfusion (the amount of blood flowing through it).

Violation of pulmonary ventilation.

Impaired ventilation

There are obstructive, restrictive and mixed disorders of the ventilation function of the lungs.

Obstructive pulmonary ventilation disorders.

The essence of obstructive pulmonary ventilation disorders is the narrowing of the total lumen of the bronchi. This is observed as a result:

Increased tone of bronchial smooth muscles (bronchospasm).

Swelling of the bronchial mucosa (it can be inflammatory, allergic, congestive).

hypersecretion of mucus by the bronchial glands (hypercreation). In this case great importance has discrinia, increased secretion viscosity, which can clog the bronchi and cause the syndrome of total bronchial obstruction.

Cicatricial deformation of the bronchi.

Valvular obstruction of the bronchi. This includes tracheobronchial dyskinesia, i.e. expiratory collapse of the trachea and main bronchi, associated with inferior structures of the respiratory tract (the leading role here is played by the pathology of cell membranes). Obstructive pulmonary ventilation disorders are characteristic of bronchospastic syndrome, which is the main one in bronchial asthma and obstructive bronchitis. In addition, obstructive disorders in animals may be associated with systemic connective tissue diseases and allergic diseases. Accumulation large quantity mucus, fluid inside the bronchi occurs when the left side of the heart fails and creates bronchial obstruction.

Restrictive ventilation disorders.

The essence of restrictive pulmonary ventilation disorders is the limitation of their expansion as a result of intrapulmonary and extrapulmonary causes.

Intrapulmonary causes of restrictive ventilation disorders are:

1) Diffuse fibrosis of various origins (alveolitis, granulomatosis, hematogenously disseminated pulmonary tuberculosis, pneumoconiosis, collagenosis).

2) Pulmonary edema of various origins (inflammatory, congestive, toxic). Edema can be alveolar and interstitial.

Extrapulmonary causes of restrictive ventilation disorders include:

Changes in the pleura and mediastinum (exudative pleurisy, pneumothorax, pleural moorings (dangerous due to restrictive changes, create conditions for lung carnification), tumors of the pleura and mediastinum, enlarged heart).

Changes in the chest and respiratory muscles (deformation chest, ossification of the costal cartilages, limited mobility of the spine, costal joints, damage to the diaphragm and other respiratory muscles, including damage to the nervous system, obesity, exhaustion).

Changes in the abdominal organs (liver enlargement, flatulence, tympany, ascites, obesity, inflammatory diseases of the abdominal organs).

Mixed pulmonary ventilation disorders.

In their pure form, obstructive and restrictive disorders of pulmonary ventilation are possible only theoretically. There is almost always some combination of both types of ventilation impairment. During restriction, fluid accumulation occurs (exudate, transudate).

1) Hyperventilation of the lungs - an increase in ventilation more than is required to saturate the blood with O 2 and release CO 2 (with excitement of the respiratory center (meningitis, encephalitis), with hypoxia, anemia, fever, lung diseases, etc.)

2) Hypoventilation of the lungs - decreased ventilation (lung disease, damage to the respiratory muscles, atelectasis, depression of the respiratory center).

3) Uneven ventilation of the right and left lungs (with unilateral damage).

4) Shortness of breath (dyspnea) - characterized by a violation of the rhythm, depth and frequency of breathing (occurs with diseases of the respiratory system, heart, physical activity, etc.)

Dyspnea- a painful, painful feeling of insufficiency of breathing, reflecting the perception increased work respiratory muscles.

The feeling of shortness of breath is formed in the limbic region, the structures of the brain, where a feeling of anxiety, fear and worry is also formed, which gives the feeling of shortness of breath the corresponding shades. The nature of shortness of breath remains poorly understood.

Shortness of breath should not include increased frequency, deepening of breathing and changes in the ratio between the duration of the inhalation and exhalation phases.

In pathology, the most various disorders breathing (external respiration, gas transport and tissue respiration) may be accompanied by a feeling of shortness of breath. In this case, various regulatory processes are usually activated, aimed at correcting pathological disorders. If the activation of one or another regulatory mechanism is disrupted, continuous stimulation of the respiratory center occurs, in particular the inhalation center, resulting in shortness of breath. Sources of pathological stimulation of the respiratory center can be:

1. Receptors for lung collapse, responding to a decrease in the volume of the alveoli. With pulmonary edema of various origins, atelectasis.

2. Receptors in the interstitial tissue of the lungs respond to an increase in fluid content in the interstitial perialveolar space.

3. Reflexes from the respiratory tract in various obstructive forms of lung pathology (obstructive emphysema).

4. Reflexes from the respiratory muscles when they are overstretched and the work of breathing increases during obstructive and restrictive disorders in the lungs.

5. Changes in the gas composition of arterial blood (a drop in the partial pressure of oxygen, an increase in the partial pressure of carbon dioxide, a decrease in blood pH).

6. Reflexes coming from the baroreceptors of the aorta and carotid artery.

by frequency by strength and duration of inhalation periodic breathing

rapid breathing 1) expiratory Cheyne-Stokes

(tachypnea) (difficulty in exhaling) Biota

rare breathing 2) inspiratory Kussmaul

(bradypnea) (difficulty breathing)

Polypnea (tachypnea)- frequent shallow breathing. This type of breathing is observed during fever, with functional disorders of the central nervous system, with lung lesions (pneumonia, pulmonary congestion, atelectasis).

Bradypnea- rare breathing. A reflex decrease in respiratory rate is observed with increasing blood pressure and with stenosis of large airways.

Hyperpnea- deep and frequent breathing. It is observed when the basal metabolism increases: during physical activity, during thyrotoxicosis, stress factors, emotional stress, fever.

Hyperpnea can cause carbon dioxide to be rapidly eliminated from the body through hyperventilation. This leads to alkalosis, a sharp drop in carbon dioxide tension in the blood, inhibition of the respiratory center, inspiration and expiration centers.

Apnea- lack of breathing. This means temporary cessation of breathing. It can occur reflexively with a rapid rise in blood pressure (baroreceptor reflex), after passive hyperventilation of an animal under anesthesia (decrease in the partial pressure of carbon dioxide). Apnea may be associated with a decrease in the excitability of the respiratory center (hypoxia, brain damage, intoxication). Inhibition of the respiratory center until it stops can occur under the influence of narcotic drugs (ether, chloroform, barbiturates) or when the oxygen content in the inhaled air decreases. Stopping breathing can occur due to mountain, altitude sickness, or sudden thin air.

Cough is classified as a breathing disorder, although this is only partly true when the corresponding changes in respiratory movements are not protective, but pathological in nature.

Example: cardiac cough due to pulmonary pathology of cardiac origin, stagnation in the lungs.

Sneezing- a reflex act similar to coughing. It is caused by irritation of nerve endings trigeminal nerve located in the nasal mucosa. The forced flow of air when sneezing is directed through the nasal passages,

Both coughing and sneezing are physiological protective mechanisms aimed at cleansing the bronchi in the first case, and the nasal passages in the second. Prolonged, debilitating cough in the animal in pathology can disrupt gas exchange and blood circulation in the lungs and requires certain therapeutic intervention aimed at relieving cough and improving drainage function bronchi.

Yawning represents deep breath with a sharply open glottis, then the inhalation effort continues with the glottis closed and reopened. It is believed that yawning is aimed at straightening physiological atelectasis of the lungs, the volume of which increases with fatigue and drowsiness. This is a kind of breathing exercises, but in pathology it develops shortly before the complete stop of breathing in dying animals, and also occurs in pathologies of the central nervous system and in neuroses.

Hiccups- spasmodic contractions (convulsions) of the diaphragm. Hiccups develop after the stomach is overfilled (an overfilled stomach puts pressure on the diaphragm, irritating its receptors). In pathology, hiccups are often of centrogenic origin and develop with brain hypoxia. It can develop under stress factors, for example, fear.

Suffocation (asphyxia) - life-threatening a pathological condition caused by an acute or subacute lack of oxygen in the blood and the accumulation of carbon dioxide in the body. Asphyxia develops due to:

mechanical difficulty in the passage of air through large respiratory tracts (larynx, trachea)

a sharp decrease in the oxygen content in the inhaled air ( altitude sickness)

damage to the nervous system and paralysis of the respiratory muscles

Mechanical difficulty in the passage of air through the large respiratory tract occurs with swelling of the larynx, spasm of the glottis, drowning, premature appearance of respiratory movements in the fetus and the entry of amniotic fluid into the fetus. Airways.

Expiratory dyspnea– at the same time, exhalation is prolonged and difficult. It occurs when the elasticity of the alveoli decreases (emphysema), spasm or blockage of small bronchi (asthma), or disruption of the respiratory centers (asphyxia). In this case, the animal tries to exhale using the abdominal muscles.

Inspiratory dyspnea– difficulty breathing (with mechanical obstruction of the respiratory tract – rhinitis, laryngitis, tumors, etc.)

Apnea – lack of breathing (blockage of the respiratory tract, poisoning, heat stroke, overexcitation of the respiratory center).

PERIODIC BREATHING

Pathological (periodic) breathing is external breathing, which is characterized by a group rhythm, often alternating with stops (breathing periods alternate with periods of apnea) or with interstitial periodic breaths.

Disturbances in the rhythm and depth of respiratory movements are manifested by the appearance of pauses in breathing and changes in the depth of respiratory movements.

The reasons may be:

abnormal effects on the respiratory center associated with the accumulation of under-oxidized metabolic products in the blood, the phenomena of hypoxia and hypercapnia caused by acute disorders of the systemic circulation and ventilation function of the lungs, endogenous and exogenous intoxications (severe liver diseases, diabetes mellitus, poisoning);

reactive-inflammatory swelling of the cells of the reticular formation (traumatic brain injury, compression of the brainstem);

primary damage to the respiratory center viral infection(encephalomyelitis of brainstem localization);

circulatory disorders in the brain stem (cerebral vasospasm, thromboembolism, hemorrhage).

Cyclic changes in breathing may be accompanied by clouding of consciousness during apnea and its normalization during the period of increased ventilation. Blood pressure also fluctuates, usually increasing in the phase of increased breathing and decreasing in the phase of weakening. Pathological breathing is a phenomenon of a general biological, nonspecific reaction of the body. Medullary theories explain pathological breathing by a decrease in the excitability of the respiratory center or an increase in the inhibitory process in the subcortical centers, a humoral effect toxic substances and lack of oxygen.

In pathological breathing there is a dyspnea phase - the actual pathological rhythm and an apnea phase - respiratory arrest. Pathological breathing with phases of apnea is designated as intermittent, in contrast to remitting, in which groups of shallow breathing are recorded instead of pauses.

CHEYNE-STOKES BREATHING.

Named after the doctors who first described this type of pathological breathing - (J. Cheyne, 1777-1836, Scottish doctor; W. Stokes, 1804-1878, Irish doctor).

Cheyne-Stokes breathing is characterized by periodic breathing movements, between which there are pauses. First, a short-term respiratory pause occurs, and then in the dyspnea phase (from several seconds to one minute), silent shallow breathing first appears, which quickly increases in depth, becomes noisy and reaches a maximum on the fifth to seventh breath, and then decreases in the same sequence and ends with the next short respiratory pause.

In sick animals, a gradual increase in the amplitude of respiratory movements is noted (up to pronounced hyperpnea), followed by their extinction until a complete stop (apnea), after which a cycle of respiratory movements begins again, also ending in apnea. The duration of apnea is 30 - 45 seconds, after which the cycle is repeated.

This type of periodic breathing is usually recorded in animals with diseases such as petechial fever, hemorrhage in the medulla oblongata, uremia, and poisoning of various origins. During a pause, patients are poorly oriented in their surroundings or completely lose consciousness, which is restored when breathing movements are resumed.

BREATH OF BIOTA

Biota breathing is a form of periodic breathing, characterized by alternation of uniform rhythmic respiratory movements, characterized by constant amplitude, frequency and depth, and long (up to half a minute or more) pauses.

It is observed in cases of organic brain damage, circulatory disorders, intoxication, and shock. Can also develop with primary lesion respiratory center viral infection (stem encephalomyelitis) and other diseases accompanied by damage to the central nervous system, especially the medulla oblongata. Biot's breathing is often observed in tuberculous meningitis.

It is typical for terminal conditions, often precedes respiratory and cardiac arrest. It is an unfavorable prognostic sign.

BREATH OF GROKK

“Wave breathing” or Grokk breathing is somewhat reminiscent of Cheyne-Stokes breathing, with the only difference that instead of a respiratory pause, weak shallow breathing is observed, followed by an increase in the depth of respiratory movements, and then its decrease.

This type of arrhythmic shortness of breath, apparently, can be considered as a stage of the same pathological processes that cause Cheyne-Stokes breathing. Cheyne-Stokes breathing and “wave breathing” are interconnected and can transform into each other; the transitional form is called "incomplete Cheyne–Stokes rhythm".

BREATH OF KUSSMAUL

Named after Adolf Kussmaul, the German scientist who first described it in the 19th century.

Pathological Kussmaul breathing (“ big breath") is a pathological form of breathing that occurs during severe pathological processes (preterminal stages of life). Periods of stopping respiratory movements alternate with rare, deep, convulsive, noisy breaths.

Refers to terminal types of breathing and is an extremely unfavorable prognostic sign.

Kussmaul breathing is peculiar, noisy, rapid without a subjective feeling of suffocation, in which deep costoabdominal inspirations alternate with large expirations in the form of “extraexpirations” or an active expiratory end. It is observed in extremely serious conditions (hepatic, uremic, diabetic coma), in case of methyl alcohol poisoning or other diseases leading to acidosis. As a rule, patients with Kussmaul breathing are in a comatose state. In diabetic coma, Kussmaul breathing appears against the background of exicosis, the skin of sick animals is dry; gathered into a fold, it is difficult to straighten out. Trophic changes in the limbs, scratching, hypotonia of the eyeballs, and the smell of acetone from the mouth may be observed. The temperature is subnormal, blood pressure is reduced, and there is no consciousness. In uremic coma, Kussmaul breathing is less common, and Cheyne-Stokes breathing is more common.

Terminal types also include GASING and APNEISTIC breathing. Characteristic feature of these types of breathing is a change in the structure of an individual respiratory wave.

GASping - occurs in the terminal stage of asphyxia - deep, sharp sighs, decreasing in strength.

APNEUSTIC BREATHING is characterized by a slow expansion of the chest, which remained in a state of inspiration for a long time. In this case, a continuous inspiratory effort is observed and breathing stops at the height of inspiration. Develops when the pneumotaxic complex is damaged.

3. Impaired function of the upper respiratory tract.

Asphyxia (suffocation) is a condition characterized by insufficient oxygen supply to the tissues and the accumulation of carbon dioxide in them. Occurs with spasms of the larynx, suffocation, drowning, foreign bodies etc. With asphyxia, cardiac dysfunction is also observed.

Pathogenesis of asphyxia:

Period 1: CO 2 accumulates in the blood - irritation of the respiratory and vasomotor centers (breathing and pulse become more frequent, blood pressure increases) - slowing of breathing - convulsions.

Period 2: Increased irritation of the vagus - breathing slows down, blood pressure and pulse decrease.

Period 3: Depletion of nerve centers, dilated pupils, muscle relaxation, decreased blood pressure, rare and strong pulse - respiratory paralysis.

4. Breathing disorder due to lung pathologies

Bronchitis is inflammation of the bronchi (due to colds, allergies, inhalation of irritating gases, dust). Inflammation of the mucous membrane, thickening, blockage of the lumen with mucus, cough, asphyxia occurs.

Spasms of small bronchi - with bronchial asthma. In this case, the vagus is excited, histamine is released - a sharp spasm of the muscles of the bronchioles - asphyxia.

Pneumonia – inflammation of the lungs (colds, infections). There is desquamation of the epithelium of the alveoli + mucus - blockage - reduction of the respiratory surface of the lungs - asphyxia. The decay products of the desquamated epithelium enter the blood, and intoxication develops.

Hyperemia of the lungs:

1) active (arterial) - increased air temperature, intoxication, irritating gases,

2) passive (venous) – bicuspid valve insufficiency, defects, myocarditis, poisoning. At the same time, blood fills the pulmonary vessels - the volume of the alveoli decreases and ventilation of the lungs decreases.

Pulmonary edema - increased air temperature, infection, intoxication, heart defects, cardiac weakness. In this case, the alveoli are filled with transudate and are compressed - asphyxia.

Pulmonary emphysema - decreased elasticity of the lungs and their stretching (heavy workload, bronchitis, cough). With an increase in respiratory movements - stretching of the alveoli - decrease in their elasticity - ruptures - expiratory shortness of breath - asphyxia. When the alveoli rupture, air escapes into the interstitial tissue.

5. Dysfunction of the pleura

Pleurisy is inflammation of the pleura. Inflammation - irritation of receptors - pain, cough, shallow breathing - accumulation of exudate in pleural cavity– compression of the lungs – asphyxia. When exudate enters the bloodstream, intoxication develops.

Pneumothorax is the accumulation of air in the pleural cavity. Causes: trauma to the chest wall with its penetrating wound, opening into the pleural cavity of a lung abscess, tuberculous cavity, foreign bodies from the mesh.

1 – open pneumothorax – when inhaling, air enters chest cavity, when you exhale, it comes out of it.

2 – closed pneumothorax – the hole is closed by suturing, the air is absorbed.

3 – valve – air enters the pleural cavity when inhaling, and when exhaling, the hole is closed by the surrounding tissues and the air cannot escape. It accumulates in the pleural cavity, compresses the lungs - atelectasis - asphyxia - death.

Impaired respiratory function due to abnormal chest structure and damage to the respiratory muscles.

Asthenic – elongated, flattened chest. In this case, breathing is difficult - the vital capacity of the lungs decreases.

Emphysematous – barrel-shaped. At the same time, breathing is also limited (exhalation) - ventilation of the lungs decreases.

Scoliosis, lordosis, immobility of vertebrae and ribs.

Damage to the diaphragm - paralysis of the respiratory center, tetanus, botulism, strychnine poisoning, tympany, ascites, flatulence.

Rib injuries, myositis.

Hiccups are irritation of the abdominal organs or phrenic nerves ( clonic seizures aperture)

HYPOXIA - oxygen starvation of tissues - is a typical pathological process that occurs as a result of insufficient supply of oxygen to tissues or disruption of its use by tissues.

Classification of types of hypoxia

Depending on the causes of hypoxia, it is customary to distinguish between two types of oxygen deficiency:

I. As a result of a decrease in the partial pressure of oxygen in the inhaled air.

II. In pathological processes in the body.

I. Hypoxia from a decrease in the partial pressure of oxygen in the inhaled air is called hypoxic, or exogenous, and develops when rising to a height where the atmosphere is rarefied and the partial pressure of oxygen in the inhaled air is reduced (for example, mountain sickness). In the experiment, hypoxic hypoxia is simulated using a pressure chamber, as well as using oxygen-poor respiratory mixtures.

II. Hypoxia in pathological processes in the body.

1. Respiratory hypoxia, or respiratory hypoxia, occurs in diseases of the lungs as a result of disturbances in external respiration, in particular disturbances in pulmonary ventilation, blood supply to the lungs or diffusion of oxygen in them, in which the oxygenation of arterial blood suffers, in cases of dysfunction of the respiratory center - in some poisonings, infectious processes.

2. Blood hypoxia, or hemic, occurs after acute and chronic bleeding, anemia, carbon monoxide and nitrite poisoning.

Hemic hypoxia is divided into anemic hypoxia and hypoxia due to hemoglobin inactivation.

Under pathological conditions, it is possible to form hemoglobin compounds that cannot perform the respiratory function. This is carboxyhemoglobin - a compound of hemoglobin with carbon monoxide (CO), the affinity of which for CO is 300 times higher than for oxygen, which makes carbon monoxide highly toxic; poisoning occurs at negligible concentrations of CO in the air. In case of poisoning with nitrites and aniline, methemoglobin is formed, in which ferric iron does not attach oxygen.

3. Circulatory hypoxia occurs in heart diseases and blood vessels and is caused mainly by a decrease in cardiac output and a slowdown in blood flow. In case of vascular insufficiency (shock, collapse), the cause of insufficient oxygen delivery to the tissues is a decrease in the mass of circulating blood.

In circulatory hypoxia, ischemic and stagnant forms can be distinguished.

Circulatory hypoxia can be caused not only by absolute, but also by relative circulatory insufficiency, when the tissue demand for oxygen exceeds its delivery. This condition can occur, for example, in the heart muscle during emotional stress, accompanied by the release of adrenaline, the action of which, although it causes expansion coronary arteries, but at the same time significantly increases the myocardial oxygen demand.

Breath is called the totality physiological processes, which provide oxygen supply to human tissues and organs. Also, during the process of breathing, oxygen is oxidized and removed from the body through the metabolism of carbon dioxide and partially water. The respiratory system includes: nasal cavity, larynx, bronchi, lungs. Breathing consists of them stages:

• external respiration (provides gas exchange between the lungs and the external environment);
• gas exchange between alveolar air and venous blood;
• transport of gases through the blood;
• gas exchange between arterial blood and fabrics;
• tissue respiration.

Violations in these processes can occur due to diseases. Serious breathing problems can be caused by the following diseases:

• Bronchial asthma;
• lung disease;
• diabetes;
• poisoning;

External signs of breathing problems allow you to roughly assess the severity of the patient’s condition, determine the prognosis of the disease, as well as the location of the damage.

Causes and symptoms of breathing problems

Symptoms of impaired breathing may include: various factors. The first thing you should pay attention to is breathing rate. Excessively rapid or slow breathing indicates problems in the system. Also important is breathing rhythm. Rhythm disturbances lead to different time intervals between inhalations and exhalations. Also, sometimes breathing may stop for a few seconds or minutes, and then reappear. Lack of consciousness may also be associated with problems in the respiratory tract. Doctors focus on the following indicators:

• Noisy breathing;
• apnea (stopping breathing);
• rhythm/depth disturbance;
• Biota breath;
• Cheyne-Stokes breathing;
• Kussmaul breathing;
• quietpnea.

Let us consider the above factors of breathing problems in more detail. Noisy breathing This is a disorder in which breath sounds can be heard from a distance. Disturbances occur due to decreased airway patency. Can be caused by diseases, external factors, rhythm and depth disturbances. Noisy breathing occurs in the following cases:

• Damage to the upper respiratory tract (inspiratory dyspnea);
• swelling or inflammation in the upper respiratory tract (shortness of breath);
• bronchial asthma (wheezing, expiratory shortness of breath).

When breathing stops, the disturbances are caused by hyperventilation of the lungs during deep breathing. Apnea causes a decrease in the level of carbon dioxide in the blood, disturbing the balance of carbon dioxide and oxygen. As a result, the airways narrow and air movement becomes difficult. In severe cases there is:

• tachycardia;
• decreased blood pressure;
• loss of consciousness;
• fibrillation.

In critical cases, cardiac arrest is possible, since respiratory arrest is always fatal to the body. Doctors also pay attention when examining depth And rhythm breathing. These disorders may be caused by:

• metabolic products (slags, toxins);
• oxygen starvation;
• traumatic brain injuries;
• bleeding in the brain (stroke);
• viral infections.

Damages to the central nervous system cause Biot's breath. Damages to the nervous system are associated with stress, poisoning, disruption cerebral circulation. May be caused by encephalomyelitis of viral origin ( tuberculous meningitis). Biot's breathing is characterized by alternating long pauses in breathing and normal, uniform breathing movements without disturbing the rhythm.

An excess of carbon dioxide in the blood and a decrease in the functioning of the respiratory center causes Cheyne-Stokes breathing. With this breathing head start, respiratory movements gradually become more frequent and deepen to a maximum, and then move on to more shallow breathing with a pause at the end of the “wave”. Such “wave” breathing is repeated in cycles and can be caused by the following disorders:

• vascular spasms;
• strokes;
• cerebral hemorrhages;
• diabetic coma;
• intoxication of the body;
• atherosclerosis;
• exacerbation bronchial asthma(attacks of suffocation).

In younger children school age similar violations are more common and usually go away over the years. Other causes may include traumatic brain injury and heart failure.

A pathological form of breathing with rare rhythmic inhalations and exhalations is called Kussmaul's breath. Doctors diagnose this type of breathing in patients with impaired consciousness. Also similar symptom causes dehydration of the body.

Type of shortness of breath tachypnea causes insufficient ventilation of the lungs and is characterized by an accelerated rhythm. It is observed in people with strong nervous tension and after heavy exercise physical work. It usually goes away quickly, but may be one of the symptoms of the disease.

Treatment

Depending on the nature of the disorder, it makes sense to contact an appropriate specialist. Since breathing problems can be associated with many diseases, if symptoms are suspected asthma contact an allergist. It will help with intoxication of the body toxicologist.

Neurologist will help restore normal breathing rhythm after shock states And severe stress. If you have a history of infections, it makes sense to contact an infectious disease specialist. For a general consultation with mild breathing problems, a traumatologist, endocrinologist, oncologist, or somnologist can help. At severe disorders breathing, you must immediately call an ambulance.