Respiratory Failure

Respiratory failure causes insufficient oxygenation or ventilation and can cause a number of symptoms, which can be severe.

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

• Fatigue

• Irregular heart rate (arrhythmia)

• Rapid breathing (tachypnea) or shortness of breath

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)

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

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.

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

• Chest trauma

• Drug or alcohol overdose

• Lung contusion (bruising)

• Near drowning

• Pneumonia

• Pneumothorax (collapsed lung)

• Pulmonary embolism (blockage of one of the main arteries going to the lungs)

• Smoke or toxin inhalation

A number of conditions may cause chronic respiratory failure, many of which are serious conditions. Examples include:

• Amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease; a severe neuromuscular disease that causes muscle weakness and disability)

• Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis

• Cystic fibrosis (buildup of thick mucus in the lungs and digestive tract)

• Guillain-Barré syndrome (autoimmune nerve disorder)

• Morbid obesity

• 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)

• Aspiration of stomach contents
• Combination of drug and alcohol use
• Multiple blood transfusions
• Severe obesity
• Shock
• Chronic obstructive pulmonary disease

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.

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

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:

• Heart failure
• Myocardial infarction (heart attack)
• Organ failure or dysfunction
• Oxygen toxicity
• Permanent lung damage
• Pneumonia
• Respiratory arrest
• Shock
• Stroke