Respiratory depression is a condition in which there is a decrease in the depth and rate of breathing. Respiratory depression can be mild and the patient does not even know that he or she is suffering from it. However, it can also cause breathing to stop completely and die. Respiratory depression can occur both from a head injury and from overdosing on various medications.

Respiratory depressionis a breathing disorder in which there is primarily a reduction in the frequency and depth of breathing. It is a potentially life-threatening condition, as it can lead to a complete stop of breathing, leading - in a relatively short time - even to the death of the patient. The centers controlling the course of gas exchange processes are located in humans within the brainstem. More precisely, they are found in the structures of the bridge and the medulla, and they perform very complex functions - incl. control the activity of the respiratory muscles (e.g. diaphragm) and maintain the appropriate frequency and depth of breathing. The so-calledthe respiratory centerreceives numerous signals from various receptors located in the human body - the main structures directing impulses to the respiratory center are the chemoreceptors located in the so-called Carotid artery glomerulus The receptors responsible for transmitting information to the respiratory center are primarily sensitive to the pH of the blood. In a situation where there is an accumulation of carbon dioxide in the body, the blood pH drops - this phenomenon causes that under normal conditions the respiratory center is stimulated and thus the respiratory rate increases. Such regulation does not always function properly - its disturbances may occur as a result of respiratory depression.

Respiratory depression: causes

Various conditions bring about respiratory depression, which disrupt the function of the brain's center that controls breathing. The main causes of respiratory depression are overdosing on various medications, such as:

  • opioid painkillers (e.g. morphine, fentanyl, oxycodone)
  • benzodiazepines (like lorazepam, diazepam or clonazepam)
  • codeine
  • pregabalina
  • zolpidem
  • haloperidol

The undesirable influence of pharmaceuticals on the structures of the brain stem, however, is not the only onepossible cause of respiratory depression. Breathing disorders can also result from:

  • consuming a significant amount of alcohol
  • stroke
  • sudden cessation of blood supply to the central nervous system
  • severe head injury
  • brainstem damage
  • drug overdoses (e.g. cocaine)
  • tumor development in the brain

Respiratory depression: symptoms

In extremely mild forms of respiratory depression, patients may not even be aware that they have any problems - a slight reduction in the frequency or depth of breathing may not be noticeable to them at all.

Respiratory depression may worsen or lead to more serious ailments right away. Conscious patients may experience a severe feeling of breathlessness and lack of air, leading to considerable anxiety. Patients may become highly agitated and anxious. Along with the further progression of respiratory disorders, patients may present an atypical breathing pattern - after a few deep breaths of air, they may experience short-term episodes of apnea. The most dangerous arethe most advanced forms of respiratory depression . The progressive impairment of the respiratory center function can lead to increasingly shallow breathing and decrease in respiration rate, eventually leading to complete respiratory stoppage. If a patient in such a situation does not reach the care of medical specialists in time, he may die within a few minutes. The complaints related to respiratory depression include not only the symptoms related to the respiratory system. Reduced oxygen supply to the body may lead to a compensatory reaction from the circulatory system - patients may experience a significant acceleration of heart activity. As the disturbances in the amount of oxygen in the body increase in patients, cyanosis may also occur in various parts of the body (especially in the area of ​​the mouth or nails).

Respiratory depression: treatment

Providing the patient with air suppliesis essential in the treatment of respiratory depression. Due to this, the patient may need to be intubated and then given machine-controlled mechanical ventilation. Other types of interventions are implemented depending on the cause of respiratory depression in the patient - in the case of cancer of the central nervous system or stroke, these are the conditions that must be treated in order to be able to resolveRespiratory depression: Specific management is for those patients who develop respiratory depression following an overdose of opioid analgesics. In such people, a special opioid antidote, naloxone, may be used. This compound is an antagonist of opioid receptors and its administration to patients suppresses the effect of these drugs leading to respiratory depression.

Respiratory depression and opioid use

Opioids are one of the most effective painkillers, but patients may be concerned about their use because of the risk of respiratory depression. However, it should be clearly emphasized here that such a risk does exist, however, doctors try to select opioid doses in such a way that the risk is as low as possible.

High doses of these preparations are usually used in hospitalized patients who, in the event of respiratory depression, will be able to provide the necessary medical help quickly. The greatest risk of these drugs is by far when the patient - for example, addicted to opioid painkillers - takes them too much. Usually, the benefits of opioids (associated with the reduction of pain) significantly outweigh the risks associated with the possibility of respiratory depression, so doctors simply recommend these drugs if necessary. Above all, patients are advised to follow the recommendations on the use of opioids - in this way, they will reduce their risk of respiratory depression.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Respiratory system