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Respiratory failure in Sickle cell disease

Sickle cell disease patients are known to develop complications, that affect the respiratory system causing respiratory failure due to insufficient oxygen supply and flow around the body. 

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Photo Credits: RC Journal

Respiratory failure would occur in sickle cell disease patients when the respiratory system fails to maintain gaseous exchange, resulting in further complications known as hypoxia or hypercapnia. Respiratory failure can be termed pulmonary failure in sickle cell disease patients. 

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Photo Credits: SpringerLink

Respiratory failure is classified according to blood gases levels in patients, as type one respiratory failure and type two respiratory failure. Type one (1) respiratory failure is the term hypoxemic: it is known to be associated with damage done to lung tissue which in turn restricts the adequacy of oxygenation of the blood in the body. However, the remaining normal lung is still sufficient still to excrete carbon dioxide. 

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Photo Credits: Postgraduate Medical Journal

This then results in low oxygen, and normal or low carbon dioxide levels. Arterial oxygen pressure has a normal range of 60mmHg with normal or low arterial carbon dioxide pressure. Type two (2) respiratory failure is the term hypercapnic: this condition is seen developed when the alveolar ventilation is inadequate to excrete the carbon dioxide being produced, inadequate ventilation is due to reduced ventilatory effort or inability to overcome increased resistance to ventilation. 


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Photo Credits: Respiratory Care

It affects the lung as a whole, and therefore carbon dioxide accumulates in the lungs, causing the arterial oxygen level to be 50mmHg. The causes of type one respiratory failure are pulmonary edema, pneumonia, chronic obstructive pulmonary disease COPD, acute respiratory distress syndrome, chronic pulmonary fibrosis, pneumothorax, pulmonary embolism, and pulmonary hypertension. 

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Photo Credits: Clinical Radiology

Type two respiratory failure is caused by: chronic obstructive pulmonary disease COPD, but may also be caused by chest wall deformities, respiratory muscle weakness, and central nervous system depression (CNS depression). Central nervous system depression is associated with reduced respiratory drive and is also often a side effect of sedatives and strong opioids. It may also be caused by severe asthma, myasthenia gravis, muscle disorders, obesity, hypothyroidism, and adult respiratory syndrome. 

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