Acute Respiratory Failure

Written by Brindles Lee Macon and Winnie Yu | Published on August 16, 2012
Medically Reviewed by George Krucik, MD


Acute respiratory failure is a condition that occurs when fluid builds up in the air sacs in your lungs. When that happens, your lungs cannot release oxygen (air) into your blood. In turn, your organs can’t get enough oxygen-rich blood to function. You can also develop acute respiratory failure if your lungs can’t remove carbon dioxide from your blood.

Respiratory failure happens when the capillaries in your air sacs cannot properly exchange carbon dioxide for oxygen. The condition can be acute or chronic. In the case of acute respiratory failure, you will experience immediate symptoms from not having enough oxygen in your body. In most cases, this failure may lead to death if not quickly treated.

Types of Acute Respiratory Failure

There are two types of acute (and chronic) respiratory failure: hypoxemic and hypercapnic. Both conditions can trigger serious complications.


There is insufficient oxygen in your blood but near normal carbon dioxide.


There is too much carbon dioxide in your blood and near normal or not enough oxygen.

What Causes Acute Respiratory Failure?

A number of things may lead to acute respiratory failure:


When something gets lodged in your throat, you may have trouble getting enough oxygen into your lungs.


Injuries that impair or compromise your respiratory system can adversely affect the amount of oxygen in your blood. For instance, if you have an injury to the spinal cord or brain can immediately affect your breathing. The brain tells the lungs to breathe. If they cannot relay messages due to injury or damage, the lungs do not continue to function properly.

Injury to the ribs or chest can also hamper the breathing process. These injuries can impair your ability to inhale enough oxygen into your lungs.

Acute Respiratory Distress Syndrome (ARDS)

ARDS is a serious condition described as low oxygen in the blood. ARDS affects you if you already have an underlying health problem such as pneumonia. It can occur while you are in the hospital being treated for that problem.

Drug or Alcohol Abuse

If you overdose on drugs or drink too much alcohol, you can impair brain function. Your brain may not tell your lungs to breathe or exhale.

Chemical Inhalation

Inhaling toxic chemicals, smoke, or fumes can also cause acute respiratory failure. These chemicals may injure or damage the tissues of your lungs, including the air sacs and capillaries.


A stroke occurs when your brain experiences tissue death or damage on one or both sides of the brain. Often, it affects only one side. Although stroke does present some warning signs such as slurred speech or confusion, it typically occurs quickly. If you have a stroke, you may lose your ability to breathe properly.

Who Is at Risk for Acute Respiratory Failure?

You may be at risk for acute respiratory failure if you:

  • smoke (tobacco products) or drink (alcohol) excessively
  • have a family history of respiratory disease or conditions
  • become injured in the spine, brain, or chest
  • have chronic (long-term) respiratory problems, such as cancer of the lungs and chronic obstructive pulmonary disease (COPD)

What Are the Symptoms of Acute Respiratory Failure?

The symptoms vary according to how healthy you are. But most people acute failure of the lungs with low oxygen levels will experience:

  • inability to breathe
  • bluish coloration in your skin, fingertips, or lips
  • passing out

When carbon dioxide is high, your heart rate may increase. You may be confused about your surroundings, who you are, and others around you.

Diagnosing Acute Respiratory Failure

Acute respiratory failure requires immediate medical attention. You may be given oxygen to help you breath and to prevent tissue death in your organs and brain.

After your doctor stabilizes you, he may perform or order specific tests to correctly diagnose your condition. Possible tests include the following:

  • a physical exam
  • inquiries about your family or personal health history
  • checking your body’s oxygen levels with a pulse oximetry device or arterial blood gas test (both measure oxygen and carbon dioxide in the blood)
  • using a chest X-ray to locate abnormal issues in your lungs

Treating Acute Respiratory Failure

Treatment usually addresses any underlying conditions you may have. Then, your doctor will treat your respiratory failure with these possible options.


Pain medications may be prescribed.


For severe cases, a tracheostomy (artificial airway in the windpipe) may be performed.

Alternative Therapies

You may be given oxygen to help you breathe better. This comes in the form of an oxygen tank or ventilator machine. Portable air tanks may be taken home if your condition requires them.

What Can I Expect in the Long Term?

If your underlying problem is treated appropriately, you will see improvement in your lung function. You may also require pulmonary rehab, which includes exercise therapy, education and counseling. Acute respiratory failure can become a long-term condition without the right treatment. It’s important to know when to seek emergency medical care.

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