Respiratory Failure
BDS (Bachelor of Dental Surgery), 6 years of experience
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What is the meaning of Respiratory Failure?
Respiratory failure is a lung disease in which the normal oxygen and carbon dioxide levels are not maintained. This disease occurs when fluid builds up in the tiny air sacs present in the lungs. When this happens, the lungs are unable to release oxygen into the blood. Due to this, the organs and muscles cannot get enough oxygen-rich blood for proper functioning.
Often lung patients have trouble breathing. Respiratory failure can also occur if the lungs cannot remove carbon dioxide efficiently from the body.
Respiratory failure can be of two types. The type of respiratory failure depends on the amount of carbon dioxide in the blood. There can be many reasons for respiratory failure, including heart failure, respiratory tract problems, pulmonary edema, etc.
Let us tell you in detail about Respiratory Failure-
- What is Respiratory Failure?
- What are the types of Respiratory Failure?
- What are the causes of Respiratory Failure?
- What are the symptoms of Respiratory Failure?
- How to diagnose Respiratory Failure?
- What are the treatments for Respiratory Failure?
- How to prevent Respiratory Failure?
What is Respiratory Failure?
Lung failure (Respiratory Failure) is a condition in which there is too little oxygen or too much carbon dioxide in your blood. Sometimes you can have both.
When you breathe normally, your lungs take in oxygen and release carbon dioxide from the body. This oxygen is taken in, and is diffused into your bloodstream. The blood carries it to your organs and muscles. The target tissue (organs or muscles) takes up oxygen from the blood and releases carbon dioxide into the blood, which is carried back to the lungs for its removal as you breathe out.
In respiratory failure, there is a disturbance in this mechanism and the gases are not diffused properly in the body. This can lead to severe symptoms which are discussed later in the article.
( Know more about- What is Chest Pain ? Home remedies for Chest Pain )
What are the types of Respiratory Failure?
Lung failure and respiratory failure are both considered similar conditions. In lung disease, the internal organs stop working. There are mainly two types of respiratory failure:
- Type 1 – In this type, the problem is because of a lack of oxygen in the blood. But the level of carbon dioxide can be high or low. This state is known as hypoxemia (lack of oxygen)
- Type 2 – In this type, the problem is because of excess carbon dioxide in the blood due to its improper removal from the body. This state is known as hypercapnia (excess of carbon dioxide)
When lung failure occurs suddenly it is known as Acute Lung Failure. When it is a long-standing condition it is known as Chronic Lung Failure.
Both the conditions can be life-threatening and should be reported to the doctor immediately.
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What are the causes of Respiratory Failure?
Some lung diseases can cause chronic respiratory failure. Respiratory failure can also be caused by conditions that affect the brain, muscles, bones, or surrounding tissue that help in breathing.
Common causes of Respiratory Failure can be seen according to the type of distress as follows:
Causes for Acute Type 1 Respiratory Failure:
- Pneumonia
- Pulmonary Oedema
- Asthma
( Know more about- What is Bronchial Asthma? )
- Pulmonary Embolism
( Know more about- What is Pulmonary Embolism? )
- Acute Respiratory Distress Syndrome (ARDS)
- Pneumothorax
- Radiation Therapy
Causes of Chronic Type 1 Respiratory Failure:
- Diseases with widespread Pulmonary Fibrosis
- Cystic Fibrosis
- Pulmonary Oedema
- Neuromuscular diseases like ALS
- Pulmonary Thromboembolism
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Causes of Acute Type 2 Respiratory Failure:
- Drugs that slow down the respiratory system like diazepam, opiates, etc
- Alcohol consumption
- Conditions causing severe obstruction to the airflow like a severe asthma attack, obstruction of the windpipe
- Trauma to the chest
- Brain stroke ( Know more about- What is the difference between Brain Stroke and Heart Attack ? )
- Trauma to the brain stem (back of your neck)
- Trauma to the spinal cord
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- Guillain Barre Syndrome (GBS)
- Muscular Dystrophy
- Polio ( Know more about- What is Polio? Symptoms and Treatment )
- Myasthenia gravis
- Botulism (It is a serious condition caused by the botulinum toxin released in the body by the microorganism, Clostridium botulinum)
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Causes of Chronic Type 2 Respiratory Failure:
- Chronic Obstructive Pulmonary Disease (COPD)
- Smoking
- Tobacco consumption
- Kyphosis
( Know more about- What is Kyphosis? )
- Scoliosis
- Marked obesity
- Neuromuscular diseases like ALS
- Hypoventilation (Shallow breathing)
Along with these causes, excessive alcohol consumption and smoking or drug abuse aggravate the condition and should strictly be avoided.
COVID-19 is also an important cause of Respiratory Failure.
( Know more about- What is Coronavirus? )
What are the symptoms of Respiratory Failure?
Symptoms may not be noticeable at first. They usually happen gradually over an extended period of time. Symptoms may include:
- Difficulty breathing or shortness of breath even when the patient is at rest
- Rapid, shallow breathing (tachypnoea which means more than 20 breaths/minute)
- Irregular heart rhythm which is known as arrhythmia
( Know more about- What are the arrhythmias of heart? )
- Cough with mucus
- Low oxygen saturation can be measured by a pulse oximeter
( Know more about- What is Pulse Oximeter? )
- Wheezing
- Bluish discoloration (cyanosis) on the skin, lips, or nails
- Fatigue
- Anxiety
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- Drowsiness
- Confusion
- Unconsciousness or fainting
- Profuse sweating
- Headache
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How to diagnose Respiratory Failure?
Your pulmonologist will diagnose respiratory failure based on:
- Your detailed medical history
- Your physical examination, which includes-
Auscultation over your chest by a stethoscope to :
- Listen to your lungs to check for abnormal sounds
- Check for arrhythmia by listening to your heart
Look for a bluish discoloration on your skin, lips, and fingernails. This is known as cyanosis and it is a common symptom seen due to insufficiency of oxygen.
After the physical examination, if your doctor thinks you might have respiratory failure, he might suggest the following diagnostic tests:
- Pulse oximetry test: Pulse oximeter is a small sensor that is most commonly fitted on your finger and it uses a light to measure how much oxygen is in your blood (Oxygen saturation of blood).
- Arterial blood gas test: It is a test that measures the oxygen and carbon dioxide levels in your blood. The blood sample is collected from your arm.
( Know more about- What is Lung Biopsy? )
Once you are diagnosed with respiratory failure, your pulmonologist will try to figure out the cause that leads to lung failure. Tests for this include:
- Chest X-ray.
- ECG (electrocardiogram)
( Know more about- What is Echocardiography? )
What are the treatments for Respiratory Failure?
In the case of lung disease, the patient requires immediate hospitalization. Doctors try to relieve the symptoms and stabilize the patient followed by identifying the underlying cause by treating it. The treatment of respiratory failure can be done in the following steps-
As soon as the patient comes into the emergency room, his airway patency is checked. If not, the doctor has to secure the airway before proceeding forward to save the patient’s life. The airway is secured by one of the following techniques:
- Endotracheal intubation: In this technique, a tube is placed in the windpipe through the mouth or nose to facilitate breathing
- Tracheostomy: An opening is made in the trachea (neck) to put a tube in the windpipe and in turn facilitate breathing
( Know more about- What is Tracheostomy? )
- Invasive Mechanical Ventilation
- Non-Invasive Ventilation
Once the airway is secured and the patient is breathing, the doctor administers supplemental oxygen as needed.
The underlying cause is explored and the doctor now focuses on controlling that. Some of the drugs used are:
- Antimicrobials for treating infections
- Bronchodilators and Steroids for controlling obstruction of the airway especially by asthma
- Diuretics, Vasodilators, Morphine, etc. to get the heart function normally
- Respiratory stimulants like nikethamide, doxapram hydrochloride, modafinil, progesterone, acetazolamide are used for some time to improve ventilation
( Know more about- What is Lung Transplant? )
How to prevent Respiratory Failure?
Some of the following measures can be adopted to prevent lung damage:
- People with lung disorders should avoid smoking.
- People who have asthma and other lung problems should get regular checkups and treatment.
- Vaccination is necessary to prevent lung problems in children
- Everyone should get the influenza vaccine
- Injuries should be treated properly to prevent lung damage
( Know more about- What is Pentavalent Vaccine? )
We hope we could answer your queries about Respiratory Failure through this article.
If you want more information about Respiratory Failure, you can contact a Pulmonologist.
We only aim to provide you with information through this article. We do not recommend any medicine or treatment to anyone. Only a doctor can give you the best advice.
