Capturing the three major signals of critical illness of respiratory tract infection
On November 17, data released by the National Administration for Disease Control and Prevention showed that influenza ranked first in the number of Class C infectious diseases nationwide in October this year. As temperatures continue to drop in various places, respiratory diseases have entered a period of high incidence. Influenza, mycoplasma pneumonia, respiratory diseases and other words are frequently searched. What are the typical symptoms of respiratory infections? How to identify and respond to severe and critical illness caused by respiratory infections? A reporter from Science and Technology Daily interviewed relevant experts.
The types of respiratory infectious diseases have not increased
“Everyone is talking about respiratory diseases recently. Before discussing, at least three concepts must be understood: respiratory infectious diseases, respiratory infectious diseases and respiratory diseases.” Professor Wang Guangfa, director of the Department of Respiratory and Critical Care Medicine at Peking University First Hospital, told reporters.
“Respiratory infectious diseases refer to notifiable infectious diseases spread through the respiratory tract, such as influenza, COVID-19, tuberculosis, etc. Respiratory infectious diseases include respiratory infectious diseases, which refer to respiratory diseases caused by foreign pathogens invading the respiratory system and causing infection. Respiratory diseases The scope is broader, including infectious respiratory diseases and non-infectious respiratory diseases.” Wang Guangfa said, “In terms of disease types, there are no new types of respiratory infectious diseases, but the number of cases may increase compared with some years. .”
From the perspective of infection invasion site, respiratory tract infections are divided into upper respiratory tract infections and lower respiratory tract infections.
“Symptoms of upper respiratory tract infection mainly include runny nose, sneezing, sore throat, etc. Symptoms such as cough, sputum, hoarseness, etc. may also occur; symptoms of lower respiratory tract infection mainly include cough, sputum, holding breath, wheezing, etc. Upper respiratory tract infection Both respiratory tract infections and lower respiratory tract infections can cause fever, muscle aches, headaches and other systemic symptoms.” Wang Guangfa said.
If severe or critical illness occurs, seek medical attention as soon as possible
After being infected with a respiratory disease, what symptoms may indicate the risk of severe or critical illness?
In this regard, Wang Guangfa said that the following three signals should be grasped.
First, symptoms of lower respiratory tract infection occur. For example, pneumonia, bronchiolitis, severe bronchitis, etc. These symptoms may affect lung ventilation, lead to hypoxia, and even cause respiratory failure. Most symptoms of upper respiratory tract infections are mild, but symptoms such as holding your breath and hoarseness that can lead to suffocation may occur.
Second, the infected people belong to a special group at high risk of severe disease. Generally, infants, young children, the elderly, and people with underlying diseases have relatively poor immunity. It is necessary to closely observe the status of these people after infection. If they develop listlessness, cyanosis (bluish-purple skin and mucous membranes), difficulty breathing, etc., it may indicate that There is a risk of severe and critical illness.
Third, the disease progresses rapidly. Respiratory tract infections caused by some special pathogens may be more likely to cause critical illness. For example, Legionella pneumonia, plague, etc., the course of the disease can progress very quickly.
“In case of serious or critical illness, you must go to the hospital as soon as possible.” Wang Guangfa emphasized.
First of all, routine examinations should be carried out, including physical examination (respiratory rate, heart rate, blood pressure, mental status, lung sounds, etc.), white blood cell examination, finger pulse oxygen saturation measurement, chest X-ray or CT. “Not everyone needs a CT scan. Infants, young children, the elderly, and people with underlying diseases whose condition progresses quickly may need a CT scan. In addition, chest X-rays or chest CT scans can also be taken when lower respiratory tract infection or pneumonia is suspected. “Wang Guangfa said.
Based on the examination results, targeted treatment will be carried out. “Treatment of severe and critical illness mainly includes two steps: the first step is to use antiviral or antibacterial drugs for effective antimicrobial treatment. The second step is to monitor the condition. If symptoms worsen or even progress to respiratory failure, treatment is necessary. In the intensive care unit, severe cases may require the use of a ventilator or even ECMO (extracorporeal membrane oxygenation equipment),” Wang Guangfa said.
Generally does not cause permanent damage to the lungs
Some people ask, will pneumonia cause permanent damage to the lungs?
“This needs to be looked at based on the patient’s basic condition, severity of illness, type of pathogen, timely treatment, tissue repair ability level, etc., and cannot be generalized.” Wang Guangfa said.
Li Hui, an associate researcher at the National Center for Respiratory Medicine, said in an interview with reporters that the lungs have the ability to repair themselves. “The recovery speed of the lungs is related to three factors: first, the severity of the lung disease, recovery from severe lung disease is slow; second, the basic condition of the patient, the elderly and people with underlying diseases recover more slowly; third, the type of pathogens infected “Pneumonia caused by bacterial infection usually recovers in about 1 month, while pneumonia caused by some viruses may take 2 months or even longer to fully return to normal.”
“In fact, for the vast majority of patients with viral pneumonia, lung damage can be recovered. However, it cannot be ruled out that a small number of viral pneumonia cases are secondary to bacterial infection, resulting in lung damage, which may affect lung function.” Wang Guangfa said.
