Respiratory Failure | Causes | Symptoms | Diagnosis | Treatment
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Respiratory Failure - Causes, Symptoms, Diagnosis, and Treatment

Published on Mar 03, 2022 and last reviewed on Feb 20, 2023   -  5 min read


A loss of functioning of the respiratory system can result in respiratory failure in severe conditions. Please read this article to know more about it.

Respiratory Failure - Causes, Symptoms, Diagnosis, and Treatment

What Is Respiratory Failure?

Respiratory failure is a pathological condition where a person's blood does not have an adequate amount of oxygen, or on the other hand, it has increased levels of carbon dioxide. Sometimes a person can have both problems. Blood is responsible for carrying oxygen into the person's organs. When a person breathes, their lungs take oxygen through the air passages, namely the trachea and the bronchus. The oxygen diffuses into the person's blood.

Organs, especially vital organs like the heart and brain, need oxygen-rich blood to work properly without causing any major life-threatening problem. Another function of breathing is removing carbon dioxide from the blood carried away from the organs and breathing it out. Having an excess amount of carbon dioxide in the blood can harm a person's organs and leads to suffocation.

What Are the Causes of Respiratory Failure?

Any pathological condition that affects the breathing of an individual can lead to respiratory failure. These conditions might indirectly affect the muscles, nerves, bones, or tissues that aid in breathing. It might also affect the lungs directly by any disease process or pathology. These conditions include the following:

What Are the Symptoms of Respiratory Failure?

The symptoms of respiratory failure occur based on the concerned etiology and the levels of oxygen and carbon dioxide in the affected person's blood. A decrease in oxygen levels in the blood can lead to shortness of breath and air hunger, affecting individuals who feel that they are unable to inhale an adequate amount of air. An increase in carbon dioxide levels can lead to rapid and forceful breathing and confusion. The person's skin, oral cavity, tongue, lips, and fingernails might present with a bluish color change called cyanosis. Some people affected by respiratory failure might experience extreme sleepiness or lose consciousness. They also may experience arrhythmia, which is an irregular heartbeat pattern. The affected person might have all the above-said symptoms if their brains and hearts are not adequately getting enough oxygen.

How Is Respiratory Failure Diagnosed?

Doctors will diagnose respiratory failure using the following tools in a hospital setting.

  • Focussed and thorough medical history of the patient.

A physical examination that often includes the following-

  • Listening to a person's lungs to look for the presence of abnormal sounds.

  • Listening to the person's heart to look out for abnormal rhythm in the person's heartbeat.

  • Look for discoloration on the person's skin, lips, tongue, buccal mucosa, and fingernails.

Diagnostic tests include the following:

  • Pulse oximetry is a small sensor machine that uses a light to measure the oxygen saturation levels in a person's blood. The sensor is frequently fitted on the end of the person's index finger or rarely on the ear.

  • Arterial blood gas measurement is a test that helps to measure the oxygen and carbon dioxide levels in the person's blood. In this process, a person's blood sample is collected from an artery, most commonly from the wrist of the individual.

Once a person is diagnosed with respiratory failure, the health care provider will check for the disease's etiology in a very focused manner. Tests at this stage often include a chest x-ray in the anterior-posterior direction. If the health care provider doubts that the person might have arrhythmia due to respiratory failure, they might check your heart rhythm pattern through an EKG. This is a very simple, painless diagnostic tool that helps detect and record the affected person's heart's electrical activity.

What Is the Goal of the Treatment?

One of the chief goals in treating respiratory failure is to increase oxygen supply mainly to the affected person's lungs and the other organs and to remove carbon dioxide from the person's body. The secondary goal is to treat the actual cause that leads to this condition.

What Are the Treatment Options?

Treatment of respiratory failure primarily focuses on:

  • Whether the respiratory failure is acute or chronic at the onset.

  • The severity of the respiratory failure.

  • The underlying etiology of respiratory failure.

  • Severe cases of respiratory failure are a medical emergency. The affected person will need treatment in the intensive care unit at a hospital for days to even months. Chronic respiratory failure can mostly be treated at home. But if there is a sudden and severe flare-up in a person's chronic respiratory failure, they might need immediate treatment in long-term care.

What Are the Types of Treatment?

  • Oxygen therapy increases oxygen saturation levels, the most primary and life-saving measure in respiratory failure patients.

  • Tracheostomy, especially in an emergency condition.

  • Mechanical ventilator support will be needed in severe as well as acute conditions.

  • Fluid replacement.

  • Medicines for symptomatic relief and the treatment of the underlying pathology.

How Is the Prognosis?

The mortality rate related to respiratory failure differs based on the etiology. In the case of acute respiratory distress syndrome, the mortality rate is approximately 40 to 45%. Younger patients less than 60 years of age have a better prognosis than older patients. Mortality also occurs in these patients admitted with a chief complaint of hypercapnic respiratory failure. This is due to underlying chronic respiratory disease and other co-morbidities like cardiopulmonary, kidney-related, hepatic, or neurologic disease. These patients are also noted to have a poor nutritional status.

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Frequently Asked Questions


Can Respiratory Failure Be Treated?

Yes, the treatment options are as follows:
- The most important and life-saving intervention for individuals with respiratory failure is oxygen treatment, which elevates oxygen saturation levels.
- Tracheostomy, especially when there is an emergency.
- Serious cases require mechanical ventilator support.
- Severe respiratory failure is considered a medical emergency. The affected person will require care in a hospital's critical care unit for days or possibly months. Most of the time, chronic respiratory failure may be treated at home. However, if a person's chronic respiratory failure flares up suddenly and severely, they might require quick treatment in long-term care.
- Administration of drugs that address both the underlying pathology and the symptoms.


Is it possible for Someone to Recover From Respiratory Failure?

Yes, it is possible that individuals having respiratory failure recover if provided the proper and adequate treatment at times, especially during emergency cases. Also, prompt treatment may prevent further complications associated with respiratory failure.


Does Respiratory Failure Mean Death?

Respiratory failure is of two types acute and chronic. Acute types occur suddenly. It happens because of a condition or injury that impairs the lungs' capacity to expel carbon dioxide or provide oxygen. Most of the time, acute respiratory failure can be fatal if it is not treated right away. However, the chronic type may happen if the airways get constricted or harmed over time. It can also happen in cases when the respiratory muscles gradually become weaker. 


Is Respiratory Failure a Serious Condition?

Yes, respiratory failure should not be taken lightly as it affects individual breathing. Respiratory failure is a serious illness that makes breathing difficult on its own. Respiratory failure happens when the lungs are unable to provide the blood with enough oxygen. 


Can Someone Survive Respiratory Failure?

Respiratory failure mortality rates vary depending on the underlying cause. The death rate for acute respiratory distress syndrome ranges from 40 to 45v%. People under the age of 60 have a better prognosis than patients above the age of 60. When these individuals present with hypercapnic respiratory failure as their primary complaint, mortality also increases. This is attributed to underlying chronic respiratory disease and associated co-morbidities such as cardiovascular, kidney-related, hepatic, or neurologic disease.


What Is the Treatment of Acute Respiratory Failure?

Acute respiratory failure may be a medical emergency that requires intubation and artificial ventilation at a hospital's intensive care unit. A tracheostomy, in which an incision is made in the front of the neck and leads directly into the windpipe, may be necessary.


Is Respiratory Failure the Same as Heart Failure?

Respiratory failure and heart failure are linked. Acute respiratory failure (ARF) is a frequent occurrence in emergency rooms in patients over 65 and is one of the main indicators of congestive heart failure (CHF) and respiratory conditions.


What Medications are Required In Treating Respiratory Failure?

Medications are required to treat the cause that has caused the respiratory failure. These medications include antibiotics which can treat bacterial lung infections like pneumonia; corticosteroids which can reduce inflammation; and bronchodilators to open or dilate the airways.


What Are the Symptoms of Respiratory Failure?

A reduction in blood oxygen levels can cause shortness of breath and air hunger, affecting individuals who feel they are unable to inhale enough air. Increased quantities of carbon dioxide can cause confusion and strong, fast breathing. The person may exhibit cyanosis, a bluish color shift, on their skin, tongue, lips, and fingernails. Respiratory failure can cause some people to become extremely sleepy or lose consciousness. They can also endure an abnormal cardiac pattern known as arrhythmia. If the brain and heart are not receiving enough oxygen, the patient may exhibit all of the symptoms listed above.


How Is Respiratory Failure Diagnosed?

Clinical symptoms, physical examination findings, and laboratory tests all contribute to a diagnosis of acute respiratory failure. The diagnostic tests include:
- A sensor device called a pulse oximeter utilizes light to gauge a person's blood oxygen saturation levels. The sensor is commonly attached to a person's index finger or, less frequently, to their ear.
- An examination known as an arterial blood gas measurement is used to gauge a person's blood levels of oxygen and carbon dioxide. A person's blood is drawn from an artery during this procedure, most frequently from the wrist.


Can Respiratory Failure Result In Memory Loss?

Yes, it is possible that respiratory failure may lead to memory loss because of the low levels of oxygen in the blood. Studies have shown an association between dementia (memory loss) and respiratory failure.


How Does Respiratory Failure Affect In The Long Run?

Long-term consequences include a noticeably increased chance of problems, such as lung damage or injury to muscles and nerves, that can cause pain and weakness. Depression and post-traumatic stress disorder (PTSD) might appear in the affected individuals.


How Much Oxygen Should a Person Have While Sleeping?

The blood oxygen level should typically be between 95 % and 100 % if an individual is obtaining enough oxygen throughout the day. The term for this is oxygen saturation. However, 90 % is seen as normal during sleep because the respiratory rate slows down as people sleep.

Last reviewed at:
20 Feb 2023  -  5 min read




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