Respiratory failure is a condition where the respiratory system is unable to get rid of carbon dioxide from the blood or have difficulty to take in adequate oxygen, leading to extremely low levels of oxygen in the blood. This condition may be acute or chronic. Acute respiratory failure is a short-term condition, that develops suddenly and it is treated as a medical emergency. While chronic respiratory failure is an ongoing problem that develops over a period of time and needs long-term treatment.

Chronic respiratory failure typically develops when the airways carrying air to the lungs become narrow and damaged, which limits air movement in the body, where less oxygen is taken in and less carbon dioxide gets out. It is also classified as hypoxemic or hypercapnic respiratory failure. Low blood oxygen levels cause hypoxemic respiratory failure, while high carbon dioxide levels lead to hypercapnic respiratory failure.
Respiratory Failure

Causes of Respiratory Failure

Generally, certain lung diseases can cause chronic respiratory failure, aside from this, health problems that hinder the way in which the brain tissue, muscles, bones or other surrounding tissues assist breathing can also lead to chronic respiratory failure.

Some of the disease conditions that commonly lead to chronic respiratory failure include:

Chronic obstructive pulmonary disease (COPD)

Severe pneumonia

Cystic fibrosis

Spinal cord injuries


Muscular dystrophy

Injury to the chest

Drug or alcohol abuse


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Symptoms of chronic respiratory failure may not be prominent initially, they progress slowly over an extended duration of time. When the symptoms develop, they may include:

Breathing difficulty or shortness of breath while exertion

Coughing with mucous


Bluish tint to the skin, lips, or fingernails

Rapid breathing





Respiratory failure is a serious illness that gets aggravated over time. As the condition becomes more severe, a patient may develop an abnormal heart rhythm, stop breathing or slide into a coma.


The doctor conducts a complete physical examination, enquires about the symptoms and medical history. Furthermore, certain blood works are also done to confirm the diagnosis.

Medical History

The doctor will ask about any prevailing lung diseases or conditions that patient presently has or had in the past to know more about the medical history.

Physical Examination

The doctor will examine the patient using a stethoscope to listen for any abnormal sounds in the lungs and heart.

Pulse Oximetry Test

Pulse oximetry is a simple and pain-free test that examines how adequate oxygen is being supplied to vital organs in the body. A small sensor device is placed on the tip of a finger or ear lobe to determine whether a patient is getting enough oxygen. Normal oxygen saturation range in healthy adults will be 96-100, while any level below 90 indicates an abnormally low oxygen level.

Arterial Blood Gas Test

This test measures the amount of oxygen and carbon dioxide in the blood. It also measures the blood pH content.

Imaging tests such as chest X-ray or CT scan are also done to obtain a better view of the lungs. In addition, bronchoscopy is also done to get a closer look at the lung passage and also collect samples of airway and lung tissue.

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Acute respiratory failure is a medical emergency that needs prompt medical attention in a hospital, chronic respiratory failure can be managed at home, depending on the nature of its cause. Some of the treatment options include:

Managing the underlying cause of respiratory failure

Eliminating excess carbon dioxide from the blood

Increasing oxygen levels in the blood

Oxygen Therapy

Oxygen therapy improves oxygen levels by increasing the amount of oxygen a patient inhale. It is distributed from a tank via a tube, the oxygen enters the lungs through a facemask, nasal tunes or a larger tube inserted into the windpipe. Small portable oxygen machines are also available that can be carried in a shoulder bag.


In more severe cases of respiratory failure, a tracheostomy may be needed which may be temporary or permanent. It is a procedure where a doctor places a tube in the windpipe that helps the patient to breathe well.

Mechanical Ventilation

If the patient condition doesn’t improve with other treatments then the doctor may put the patient on a ventilator or breathing machine. This machine pumps oxygen via a tube that is placed into mouth or nose and down into windpipe. As the ventilator blows air directly into the lungs, the patient don’t have to work hard to breathe oxygen on his own. Other forms of breathing aid known as non-invasive ventilation (NIV) include BiPAP and CPAP.