Causes of suffocation

The causes of asphyxiation can be grouped as follows.

1. Narrowing or closing of the airway lumen.

• Causes of suffocation, acting inside the respiratory tract or associated with airway disease.
  • Ingestion of foreign bodies, vomit, water.
  • Blockage of mucus, fibrinous (with diphtheria), plaque, tongue westernization.
  • Stenosis of the larynx with influenza and SARS ("false cereal"), as well as against bacterial infections (sore throats).
  • Vocal cords dysfunction syndrome.
  • Spasm of respiratory muscles, pronounced edema of the respiratory tract.
  • The cause of asthma can be bronchial asthma, bronchiolitis, carcinoid syndrome, systemic mastocytosis, systemic connective tissue diseases, chronic obstructive bronchitis of severe course, LA, anaphylaxis, beta-adrenoblockers. Choking can also occur as a result of an acute inflammatory process in the lungs (pneumonia). There are also asthma-like conditions in athletes (hyperactivity of the respiratory tract without the formation of bronchial asthma), mainly in skiers due to the inhalation of cold air, less often - in athletes.
  • Local edema of the respiratory tract (AO, hereditary AO).
  • Tumors of the larynx, trachea, bronchi.
  • Paralysis of the respiratory musculature (poliomyelitis, myasthenia gravis).
  • Anomalies in the development of the trachea and bronchi.
• Causes of suffocation from outside:
  • compression of the neck and thorax organs in case of accidents, strangulation and similar situations;
  • defeat of the lymphatic apparatus and subcutaneous tissue of the neck in the pharyngeal and paratonsillar abscess, infectious mononucleosis, Ludwig's angina;
  • tumor diseases of other organs (mediastinal tumors, mediastinal lymph nodes, lymphosarcoma, lymphogranulomatosis), aortic aneurysm; pneumothorax.

2. Cardiovascular causes of suffocation: thromboembolism of the branches of the pulmonary artery, parietal thrombosis of the pulmonary artery, myocardial infarction, heart defects, pericarditis, periarteritis nodosa, acute tachyarrhythmias of the heart, pulmonary edema, as a consequence of heart failure.
3. Paralysis of the respiratory center; poisoning with poisons that cause paralysis or spasm of the respiratory muscles or impair the ability of the blood to transport oxygen.
4. Nocturnal apnea - nocturnal asphyxia, which is not a manifestation of a specific cardiovascular or respiratory disease, most often occurs in people with excessive body weight (hypersthenicides), especially with abdominal obesity, but may also be in normostenics.
5. Psychogenic suffocation.

[1], [2], [3], [4], [5], [6], [7]

Why does suffocation develop?

The mechanism of development of suffocation is determined by etiological factors. This may be an obstacle to the passage of air in the respiratory tract (mechanical, upper airway stenosis, bronchial obstruction, etc.), pulmonary edema, damage to the respiratory center or respiratory muscles.

Choking in bronchial asthma develops as a result of a spasm of the smooth muscles of the respiratory tract, edema of the mucous membrane, the release of thick and viscous mucus. In severe cases, significant areas of the bronchopulmonary system ("mute lung" during auscultation) are turned off from gas exchange. In combination with the ineffective of whose standard bronchodilator therapy this leads to the development of asthmatic status (status asthmaticus). At the same time, severe respiratory failure develops with violations of the gas composition of the blood and drainage function of the bronchi.

Choking can develop with diseases accompanied by the production of biogenic amines:

Carcinoid is a tumor consisting of cells of the APUD system producing serotonin, bradykinin, prostaglandins. Bronchospasm occurs when the tumor is located in the bronchus (although this localization is only 7% of cases, more often the tumor is localized in the digestive organs).

Systemic mastocytosis (mast cell reticulosis) - choking resembles the symptoms of bronchial asthma. Bronchospasm is associated with the release of mast cells by a large amount of histamine.

Laryngeal edema - suffocation is associated with localization of edema in the upper respiratory tract, in the neck, throat.

And also with the following pathologies:

Thrombemolia of the pulmonary artery - the source of emboli in most cases - phlebothrombosis of pelvic organs and lower

Obstruction of the upper respiratory tract often occurs in children. In its genesis lie the anatomical and physiological characteristics of the child:

• Narrowness of the respiratory tract;
• The loose subglottic space of the larynx;
• Relative weakness of the respiratory muscles.

Viral infections and allergic reaction in such conditions quickly lead to swelling, mucus secretion and the development of stenosis. The true croup in diphtheria is associated with the formation of fibrinous films on the vocal cords.

Decreased functional activity of the left ventricle (for example, after myocardial infarction) leads to stagnation of blood in a small circle of blood circulation, disruption of gas exchange and development of suffocation, called "cardiac asthma." With a sharp weakening of myocardial contractility of the left ventricle, the right ventricle continues to work hard, pumping blood from a large circle of circulation and a small one. The extreme manifestation of this process is pulmonary edema. Respiratory relief in the sitting position is due to a decrease in the influx of venous blood to the heart, a decrease in hydrostatic blood pressure in the upper parts of the lungs and an increase in the ZHEL. The frequent occurrence of seizures at night is due to the increased activity of the vagus nerve at this time, which leads to a narrowing of the coronary arteries, a deterioration in myocardial nutrition, and an increase in the tone of the bronchi. In addition, during sleep, the blood supply of the respiratory center decreases and its excitability decreases.

Endobronchial growth of the tumor (for example, adenoma) leads to the fact that the clearance of the bronchus gradually decreases and at a certain stage the valve stenosis develops: the bronchus lumen is passable on inhalation and completely closes on exhalation, causing an attack of expiratory dyspnea or suffocation. A similar valve mechanism is constantly present in the congenital anomaly - tracheobronchomegaly, when the excessively developed membrane part of the trachea briefly blocks the lumen, which is manifested by a sensation of suffocation, and therefore it is erroneous to assume the presence of bronchial asthma.

Valve pneumothorax - valvular mechanism of air accumulation in the pleural cavity with gradual development of severe suffocation - develops with a trauma of the lung, bronchial cancer, pneumonia.

The type of stridor also depends on the nature of the pathological process.

• Inspiratory stridor indicates a lesion in the area of the glottis or above the area.
• Mixed stridor is characteristic for diseases of the vocal apparatus and trachea.
• The expiratory stridor is observed with bronchial obstruction, foreign body aspiration, compression of the bronchi with enlarged lymph nodes, malignant lymphoma in the region of the roots of the lungs.