Respiratory failure is a condition when the lungs are unable to exchange oxygen and carbon dioxide effectively, resulting in dangerously low oxygen levels or high carbon dioxide levels in the blood. Respiratory failure can develop gradually (chronic) or manifest suddenly (acute).
Respiratory Failure Symptoms
Respiratory failure symptoms depend on the cause. These may include:
Shortness of breath or dyspnea
Rapid breathing (tachypnea)
Fatigue
Fast heart rate or heart palpitations
Coughing bloody mucus or blood (hemoptysis)
Restlessness
Pale skin
Excessive sweating
Bluish lips, skin or nails (cyanosis)
Blurred vision
Headaches
Confusion or agitation
Behavioral changes
Respiratory Failure Causes
Respiratory failure occurs due to the following causes:
Insufficient blood flow or airflow to the lungs.
Scarring, fluid or blockages in the lungs.
Inability to breathe deeply enough or properly. This can be caused by conditions that affect lungs, issues with the muscles or nerves and injuries to the chest.
Abnormalities in the flow of blood through the heart.
Respiratory Failure Types
Respiratory failure can start suddenly (acute) or over a span of time (chronic). The common types of respiratory failure include:
Hypoxemic Respiratory Failure
Hypoxemic respiratory failure occurs when the blood does not have enough oxygen (hypoxemia). Heart disease and lung conditions are the most common causes of hypoxemic respiratory failure.
Hypercapnic Respiratory Failure
Hypercapnic respiratory failure occurs due to excessive carbon dioxide (CO2) in the blood. If the body is unable to remove carbon dioxide, a waste product, this leaves little to no room for the oxygen carrying blood cells.
Perioperative Respiratory Failure
This type of respiratory failure includes respiratory complications that occur during or after surgical procedures, particularly those of the chest and abdomen. For some people, anesthesia keeps them from breathing properly.
Respiratory Failure Due to Shock
Shock is a condition causing low blood pressure, fluid buildup in the lungs and other issues leading to respiratory failure. Cardiac conditions like heart attack and blood loss can also cause shock.
Respiratory Failure Risk Factors
Respiratory failure risk factors include:
Age: Adults over the age of 65 and premature infants are at a greater risk of respiratory failure.
Obesity: Being obese can impair lung function and increase the risk of respiratory failure.
Exposure to lung irritants: Smoking or exposure to passive smoke, air pollution, dust and chemical fumes increases the risk of respiratory failure.
Lung diseases: Conditions like chronic obstructive pulmonary disease (COPD), asthma, pneumonia, cystic fibrosis, acute respiratory distress syndrome (ARDS).
Neuromuscular disorders: Conditions that affect the nerves and muscles contributing to breathing. This may include muscular dystrophy, severe scoliosis and amyotrophic lateral sclerosis (ALS).
Alcohol and drug use: Excessive alcohol consumption and drug use impairs respiratory function, increasing the risk of respiratory failure.
Respiratory Failure Diagnosis
The following tests can help confirm a respiratory failure diagnosis:
Pulse oximetry- This test helps detect the amount of oxygen in the blood.
Arterial blood gas (ABG) test- A blood sample is collected from the wrists, arm or groin to measure the level of carbon dioxide and oxygen in the blood.
Lung function tests- Also referred to as pulmonary function tests, these tests help understand the functioning of the lungs.
Imaging tests: A doctor may use CT scans and X-rays to help detect the cause of respiratory failure.
Electrocardiogram (EKG): An EKG detects the functioning of the heart. If a pulmonologist suspects that a heart condition is causing respiratory failure, they may recommend getting an EKG done.
Respiratory Failure Treatment
Treatment for respiratory failure include:
Mechanical ventilation: A doctor uses a breathing machine and tube that reaches the airways to move air in and out of the lungs.
Extracorporeal membrane oxygenation: This treatment involves using a bypass machine to add oxygen to the blood and remove carbon dioxide.
Oxygen therapy: Often the first step in respiratory failure treatment, oxygen therapy involves using a cannula or a breathing mask to deliver extra oxygen.
Fluids: In some cases, fluids can be given directly to a vein through an IV. This improves the blood flow through the arteries and brings more oxygen to the tissues.
Non-invasive ventilation: For some individuals, non-invasive ventilation methods such as Continuous Positive Airway Pressure (CPAP) can be effective. This type of treatment also helps improve oxygenation without intubation.
Medications: Certain medications that helps manage respiratory failure and its causes include:
Bronchodilators help relax the airways, for easier breathing.
Steroids reduce the level of inflammation in the lungs, helping improve breathing.
Antibiotics may also be prescribed in cases of infection to help improve breathing and reduce inflammation.
Pulmonary rehabilitation: It is a structured program combining exercise training, education and support to help improve lung function and overall quality of life.
FAQs
What are the four types of respiratory failure?
The two common types of respiratory failure include:
Hypoxemic respiratory failure related to lack of oxygen in the blood and hypercapnic respiratory failure due to excessive carbon dioxide in the blood. Other types of respiratory failure include perioperative respiratory failure related to surgery and respiratory failure due to shock.
What are the 4 common respiratory problems?
Chronic respiratory diseases affect the airways and other structures in the lungs. Some of the most common respiratory problems are asthma, chronic obstructive pulmonary disease, pulmonary hypertension and occupational lung diseases.
Is it possible to prevent respiratory failure?
It is not always possible to prevent respiratory failure. However, you can reduce the risk of chronic respiratory failure by managing existing cardiac, pulmonary and neurological conditions.
Is respiratory failure curable?
Treatment for respiratory failure includes medicines, oxygen therapy, and procedures to help the lungs heal. Chronic respiratory failure can be treated at home, however for severe chronic respiratory failure, treatment in a long-term care centre is crucial.
