Acute And Chronic Respiratory Failure
Respiratory failure is when your lungs have difficulty supplying your blood with oxygen or removing carbon dioxide. It can leave you with low oxygen, high carbon dioxide, or both.
Types of Respiratory Failure
If you aren’t getting enough oxygen into your blood, it is hypoxemic or type 1 respiratory failure. If you have too much carbon dioxide along with hypoxemia, it’s called hypercapnic or type 2 respiratory failure.
Acute respiratory failure comes on quickly, and it’s an emergency. But respiratory failure can also be chronic, a long-term problem that you’ll need regular care to manage.
Acute. You’ll go to an ER, but if your treatment doesn’t solve the problem, you may need to stay overnight. You may need to go to the intensive care unit (ICU) for severe symptoms. You may get oxygen therapy. And you may need a ventilator until you can breathe on your own. You’ll also get medicine and fluids to ease your symptoms and treat the cause of your respiratory failure.
Chronic. You’ll get ongoing care in your home, which typically includes daily medication- inhaled or drugs you take by mouth. In severe cases, you might need oxygen therapy or one of the smaller ventilators, like a CPAP or BiPAP machine, to get more air into your lungs.
What Causes It?
Breathing may seem simple, but there are many moving parts. A problem with any one of them can lead to respiratory failure, including:
- Injury to your chest or ribs
- A drug or alcohol overdose
- Lung damage from breathing in smoke
- Lung disease or infection, like chronic obstructive pulmonary disease (COPD), cystic fibrosis, or pneumonia
- Muscle and nerve damage from conditions like amyotrophic lateral sclerosis (ALS), spinal cord injuries, and stroke
- Scoliosis or other spine problems can affect bones and muscles involved in breathing
- Blocked blood flow to your lung, like with a blood clot
Acute respiratory failure is more familiar with an injury to your brain, chest, or lungs. C choking, drowning, or getting hit in the chest could all do it. A sudden, severe illness that affects breathing, like acute respiratory distress syndrome (ARDS), can also bring it on.
Risk Factors for Respiratory Failure
You might have a higher risk of respiratory failure if you:
- Have long-term respiratory problems like COPD or asthma or ILD
- Smoke
- Chest wall abnormalities like kyphoscoliosis or obesity
- Have a family history of respiratory problems
- Neuromuscular disorders
What Are the Symptoms?
Your symptoms will depend on the cause and whether you have low oxygen, high carbon dioxide, or both. Some things you may notice are:
- Bluish color to your fingernails, lips, and skin
- Feeling that you can't take in enough air
- Confusion
- A heartbeat that's off
- Rapid breathing or prolonged breathing
- Shortness of breath
- Sleepiness or passing out
Respiratory Failure Diagnosis
Pulse oximetry. Your doctor puts a small device on your finger or ear to measure your oxygen level.
Arterial blood gas test. This basic blood test measures your levels of oxygen and carbon dioxide.
You may need more tests to look for the cause. That could include a chest X-ray or an EKG, which measures electrical signals in your heart.
Respiratory Failure Treatment
Oxygen therapy. You breathe in oxygen through a mask or a thin tube with two prongs that sit just inside your nose. You can get a portable oxygen tank to go out still and about with it.
Ventilator. You might need one of these breathing machines if oxygen therapy isn’t enough or you can’t breathe alone. They blow air into your lungs so you get the oxygen you need without working so hard for it. They also help lower carbon dioxide levels.
Treating the cause. You might also need care for the condition that caused your respiratory failure. That could mean things like:
- Antibiotics for pneumonia
- Drugs to break up blood clots
- Inhaled medicines to open airways
- Chest tube to drain blood or extra air in cases of injury
Your treatment will depend on the cause and whether your respiratory failure is chronic or acute. Acute and chronic cases aren’t treated similarly, but the ideas are similar.
Respiratory Failure Prognosis
If you have acute respiratory failure, treatment right away can help get you back to your normal activities. With chronic respiratory failure, following your doctor’s advice about ongoing care is essential. Know what your symptoms mean and when to call your doctor.
Respiratory failure is severe, but many things can affect how you do it, including what’s causing your condition.
Dr. Sheetal Chaurasia is the senior Consultant – Pulmonary Medicine at Manipal Hospital Whitefield Bangalore. With experience spanning over two decades in the medical field, she is recognized as one of the most reputed Consultant pulmonologists in Manipal Hospital Whitefield Bangalore.
