What is Respiratory Depression?
Respiratory Depression is a medical condition in which the breathing rate of an individual is far below the normal levels. As a result of this, there is less of oxygen and more of carbon dioxide in the blood. It is quite a serious situation in that low oxygen levels can cause severe malfunctioning of organs in the body leading to life threatening complications. The whole respiratory system is controlled by the brain and thus anything that affects the functioning of the brain or depresses the central nervous system can cause Respiratory Depression[3].
Shallow breathing is the primary presenting feature of Respiratory Depression. Treatment with mechanical ventilation and oxygen supplementation forms the front line treatment approach for Respiratory Depression. Alcohol, sedatives, narcotics all suppress the brain function and hence can cause Respiratory Depression[3].
There are also certain medical disorders that may result in an individual having Respiratory Depression. Conditions in which the breathing of an individual gets affected like asthma or COPD if left untreated can cause this condition. If there are abnormalities in the lungs causing problems with gas exchange can also result in Respiratory Depression[1].
People who are obese are at increased risk for this condition. Even though the role of obesity in Respiratory Depression is not clear, according to studies obesity when combined with obstructive sleep apnea which is common in overweight individuals is a crucial factor in Respiratory Depression. People with neurological and neuromuscular disorders also are at increased risk for developing this disorder. This can be explained by the weakness in the muscles of the respiratory system affecting breathing of an individual[1].
In some cases, there is an abnormality in the respiratory control due to defect in certain genes. This also forms one of the reasons for an individual having Respiratory Depression. Treatment for all cases of Respiratory Depression involves treating the underlying disorder and providing necessary oxygen normally by way of mechanical ventilation to prevent malfunctioning of the vital organs of the body[1].
How is Respiratory Depression Treated?
As stated, the front line approach towards management of Respiratory Depression is to treat the underlying cause. This involves adjustment of doses or giving alternative medication in cases where breathing or muscular function is affected by medications. People who are on benzodiazepines and other psychiatric drugs need to be monitored carefully for Respiratory Depression and the dose should be adjusted wherever required[2].
It is also important to improve the functionality and efficiency of the respiratory muscles so that breathing is normalized. Weight management is also an important factor when managing Respiratory Depression especially in people with obstructive sleep apnea. People who have healing vertebral fracture or have had treatment for conditions like kyphoscoliosis should also be monitored as they all can lead to problems with breathing resulting in Respiratory Depression[2].
In some cases, electric stimulation of the diaphragm is also done to improve quality of breathing and treat Respiratory Depression. Even with all the above, it may not be possible to treat all the patients with this condition. Thus mechanical ventilation plays an important role as it forms the mainstay of symptomatic therapy for treatment of Respiratory Depression[2].
Noninvasive ventilation is the most preferred way of treating breathing abnormalities like Respiratory Depression. This form of ventilation works by generating tidal volumes via pressure controlled ventilation where the inspiratory and expiratory pressure difference remains constant throughout[2].
Other than this, if the condition is caused by medication overdose or substance abuse like alcohol then detoxification should be done on an urgent basis to normalize breathing. CPAP and BiPAP are also methods through which Respiratory Depression can be treated successfully[3].
