A health condition in which there is not enough oxygen or too much carbon dioxide in the body is called respiratory failure. While it may occur all at once (acute), it may also come over time (chronic). In general, there are multiple health conditions that can cause it. However, the acute form of respiratory failure is life-threatening, and without immediate treatment, it may lead to death. If you or someone near you develops symptoms of acute respiratory failure, immediately call 911 or go to the nearest emergency room.
In other words, this condition occurs when you do not have enough oxygen (hypoxia) or too much carbon dioxide in the blood (hypercapnia). Sometimes, this disorder is called acute hypoxemic respiratory failure (AHRF).
Types of Respiratory Failure
Healthcare professionals have divided this condition into several types. These include hypoxemic respiratory failure (type 1), hypercapnic respiratory failure (type 2), perioperative respiratory failure (type 3), and respiratory failure due to shock (type 4).
Hypoxemic Respiratory Failure
This type of respiratory failure often occurs when you do not have enough oxygen in the blood (also known as hypoxemia). The most common causes of this type of respiratory failure are lung and heart conditions. Sometimes, it is called hypoxic respiratory failure.
Hypercapnic Respiratory Failure
In such cases, people have too much carbon dioxide (CO2) in the blood. However, when the body cannot get rid of CO2, which is a waste product, there is no remaining space for oxygen-rich blood cells. In most cases, people develop this type of respiratory failure due to lung, heart, muscle, and neurological (brain and spinal cord) disorders. However, some people may develop hypercapnic respiratory failure (sometimes called hypercarbic respiratory failure) due to some medications.
Perioperative Respiratory Failure
This type of respiratory failure often happens when you have surgery. Moreover, anesthesia (medicines that keep you asleep) may also affect breathing. In some cases, the air sacs in the lungs may collapse (atelectasis), which prevents oxygen from getting into the blood.
Respiratory Failure Caused by Shock
A health condition that causes hypotension (low blood pressure), pulmonary edema (fluid buildup in the lungs), and other disorders that eventually lead to respiratory failure is called shock. Furthermore, people usually experience shock due to sepsis, heart diseases (including a myocardial infarction), and blood loss.
Symptoms
Check below some symptoms that people who develop respiratory failure often experience:
- Dyspnea (shortness of breath or a feeling that you cannot get enough air)
- Tachypnea (fast breathing)
- Fatigue (extreme tiredness)
- Heart palpitations
- Fast heart rate
- Hemoptysis (coughing blood or bloody mucus)
- Excessive sweating
- Pale skin
- Restlessness
- Cyanosis (bluish skin, lips, or nails)
- Vision changes (such as blurred vision)
- Headaches
- Behavioral changes
- Confusion
- Agitation
If any of the previous symptoms occur, immediately contact your healthcare provider.
Causes
Usually, people develop respiratory failure when something prevents the body from getting oxygen into the blood or getting rid of CO2. Check some causes of respiratory failure below:
- Reduced airflow or blood flow to the lungs
- Scarring, blockages, or fluid in the lungs
- Inability to breathe properly or deeply enough (it often occurs due to disorders that cause problems with the nerves or muscles involved in breathing)
- Irregularities in the way blood flows through the heart muscle
Risk Factors
Healthcare professionals have identified some factors that could increase your risk of developing respiratory failure. Check below some examples:
- Lung disorders – These include chronic obstructive pulmonary disease (COPD), pneumonia, asthma, cystic fibrosis, pulmonary edema, pulmonary embolism or fibrosis, and acute respiratory distress syndrome (ARDS).
- Heart or circulatory disorders – For example, heart attack (myocardial infarction), congenital heart disease, heart failure, and shock.
- Health conditions that affect the muscles and nerves involved in breathing – Examples include muscular dystrophy, amyotrophic lateral sclerosis (ALS), severe scoliosis, and Guillain-Barré syndrome.
- Smoking (if you face problems with smoking cessation, discuss it with your healthcare professional)
- Prolonged exposure to certain chemicals (such as chemical fumes, dust, and Asbestos)
- Surgery that needs sedation or anesthesia
- Misuse of recreational drugs or alcoholic drinks
- Age – Newborns and older adults (over 65 years old) are more likely to develop respiratory failure.
What Are The Potential Complications of Respiratory Failure?
People who develop respiratory failure may also experience some complications, especially if they ignore the symptoms and do not get treatment. For example:
- Pulmonary fibrosis (scarring of the lungs)
- Arrhythmia (irregular heart rhythm)
- Seizures
- Stroke
- Urinary tract infections (UTIs)
- Pulmonary hypertension
- Cognitive impairment
- Muscle weakness
- Kidney failure
- Death
This document does not contain a full list of respiratory failure complications. However, you can consult with your doctor about ways to reduce the risk or prevent previous complications.
How to Prevent Respiratory Failure?
Unfortunately, it is not always possible to prevent respiratory failure. However, you can consider the following tips to reduce the risk. For example, managing heart, lung, and neurological disorders, quitting smoking, and limiting or avoiding alcoholic drinks. Talk with your doctor for more details.
Diagnosis
Doctors often diagnose this condition by testing the amount of oxygen and CO2 in the blood. First, they check the blood pressure and may use a small device (pulse oximeter) to check your oxygen levels. However, in some cases, they need to perform the following tests to confirm the condition and determine what exactly causes it. For example:
- Arterial blood gas (ABG) test – This test uses a needle to take a small sample of blood from the wrist, arm, or groin to measure levels of oxygen and CO2 in the blood.
- Lung function tests – These tests are also known as pulmonary function tests (PFT), and they involve a mouthpiece that is attached to a machine to determine how well your lungs work.
- Imaging tests – These tests are usually used to get detailed images of different structures and organs in the body. While they cannot diagnose respiratory failure, your doctor may get more clues about the disease.
- Electrocardiogram (ECG or EKG) – This test is used to measure the electrical activity of the heart. It helps determine how well your heart is working.
Treatment
The treatment for people with respiratory failure is often different because it depends on several factors. These include the severity of the condition, the underlying cause, overall health, age, and preferences. While acute respiratory failure is a medical emergency that requires immediate treatment, a mild chronic respiratory failure can be managed with home remedies and treatment for the underlying cause. Check below some treatments usually prescribed by doctors for people with respiratory failure:
- Mechanical ventilation – During this procedure, doctors use a machine and a tube that helps move air in and out of the lungs.
- Extracorporeal membrane oxygenation (ECMO) – This treatment involves a bypass machine that helps add oxygen to the blood and remove CO2.
- Oxygen therapy – This treatment also involves a machine and a mask that delivers extra oxygen.
- Fluids – In some cases, doctors may prescribe intravenous (IV) fluids to improve blood flow, which helps bring more oxygen to the tissues.
Furthermore, doctors may also prescribe other treatments for the underlying cause. These may include medicines, procedures, and surgery (rarely).
Frequently Asked Questions
Can you survive with respiratory failure?
In general, this is a very serious disorder, but most people survive it. While most cases of acute respiratory failure are successfully treated, it may lead to death without immediate treatment. About 30% of people with acute respiratory failure do not survive. However, if you develop a chronic form of respiratory failure, it often worsens over time.
When should I go to the ER?
If you experience severe symptoms of respiratory failure, you should call 911 or go to the nearest emergency room (ER). Otherwise, the condition can be fatal.
How long does it take to recover from respiratory failure?
While most people recover completely within a few weeks, some people may recover up to 1 year or even more. It depends on the severity of the condition, how quickly you get the treatment, and other factors. Ask your healthcare provider if you have additional questions.
