What is respiratory failure?
Respiratory failure is the inability of the respiratory system to adequately supply fresh oxygen or remove carbon dioxide, resulting in low blood oxygen or high blood carbon dioxide levels, respectively. Multiple conditions can cause one or both of these problems. Acute or sudden respiratory failure can happen as the result of trauma, injury, drug or alcohol overdose, or inhalation of carbon monoxide. Chronic, or long-term, respiratory failure is commonly caused by chronic obstructive pulmonary disease (COPD), neuromuscular disease, or even morbid obesity.
The signs and symptoms of respiratory failure differ depending on the severity and underlying cause. Acute respiratory failure occurs rapidly and can resolve with treatment. Chronic respiratory failure, on the other hand, is a progressive disease, which typically worsens over time. Symptoms of respiratory failure include difficulty breathing, cyanosis (blue or purple coloration of the skin), and lethargy. Treatment depends on the severity of the disease and may include oxygen support, bronchodilators, and ventilatory support.
Respiratory failure can be a serious or life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms, such as severe difficulty breathing; severe sharp chest pain; bluish coloration of the lips or fingernails; a change in level of consciousness or alertness, such as passing out or unresponsiveness; and rapid heart rate.
Seek prompt medical care if you are being treated for respiratory failure but mild symptoms recur or are persistent.
What are the symptoms of respiratory failure?
Respiratory failure causes insufficient oxygenation or ventilation and can cause a number of symptoms, which can be severe.
Common symptoms of respiratory failure
Respiratory failure is accompanied by a number of symptoms including:
Bluish coloration of the lips or fingernails
Confusion or loss of consciousness
Fainting or change in level of consciousness or lethargy
Irregular heart rate (arrhythmia)
Rapid breathing (tachypnea) or shortness of breath
Serious symptoms that might indicate a life-threatening condition
In some cases, respiratory failure can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
Bluish coloration of the lips or fingernails
Change in level of consciousness or alertness, such as passing out or unresponsiveness
Rapid heart rate (tachycardia)
What causes respiratory failure?
Respiratory failure is the inability of the respiratory system to supply oxygen or remove carbon dioxide, resulting in low blood oxygen or high blood carbon dioxide levels. Multiple conditions can cause one or both of these problems. Respiratory failure can transpire quickly as the result of trauma, injury, drug or alcohol overdose, or inhalation of carbon monoxide. Chronic, or long-term, respiratory failure is commonly caused by chronic obstructive pulmonary disease (COPD), neuromuscular disease, or even morbid obesity.
Causes of acute respiratory failure
A number of conditions may cause acute respiratory failure, many of which are life-threatening or serious conditions. Examples include:
Acute asthma attack
Acute respiratory distress syndrome (life-threatening respiratory condition)
Carbon dioxide poisoning
Drug or alcohol overdose
Lung contusion (bruising)
Pulmonary embolism (blockage of one of the main arteries going to the lungs)
Smoke or toxin inhalation
Causes of chronic respiratory failure
A number of conditions may cause chronic respiratory failure, many of which are serious conditions. Examples include:
Cystic fibrosis (buildup of thick mucus in the lungs and digestive tract)
Guillain-Barré syndrome (autoimmune nerve disorder)
Myasthenia gravis (autoimmune neuromuscular disorder that causes muscle weakness)
Pulmonary fibrosis (damaged and scarred lung tissue)
Sarcoidosis (inflammatory disease most commonly affecting the lungs, skin and eyes)
Severe curvature of the spine (scoliosis)
What are the risk factors for respiratory failure?
- Aspiration of stomach contents
- Combination of drug and alcohol use
- Multiple blood transfusions
- Severe obesity
- Chronic obstructive pulmonary disease
How is respiratory failure treated?
Treatment for respiratory failure begins with seeking medical care from your health care provider. The goals of treatment for respiratory failure are to increase oxygenation and improve ventilation. Treatment depends on the severity of the respiratory failure and the cause. Acute respiratory failure treatment will address the underlying cause and include ventilation and oxygenation as needed. Treatment for chronic respiratory failure may be administered at home. Exacerbation of chronic respiratory failure by infection may require hospitalization, and treatment may include oxygenation and ventilator support. Bronchodilators may improve airway patency.
Respiratory failure treatment options
Multiple options are available for the treatment of respiratory failure. Examples include:
Antibiotics for respiratory infections
Bilevel positive airway pressure (BiPAP)
Bronchodilators, including anticholinergics, such as tiotropium (Spiriva), or beta agonists, such as albuterol (Proventil)
Continuous positive airway pressure (CPAP)
Inhaled steroid medications to decrease inflammation
Lung transplant, in rare cases
Mechanical ventilation, if oxygen therapy if not sufficient to increase blood oxygen levels
Oxygen therapy to increase blood oxygen levels
Tracheostomy, a hole made in the front of the neck to help you breathe
What are the potential complications of respiratory failure?
Complications of untreated respiratory failure can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of respiratory failure include: