Chronic Respiratory Failure

Written by April Kahn | Published on August 7, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What is Chronic Respiratory Failure?

When you breathe, you take in oxygen-rich air. This oxygen moves through the bloodstream and into the organs and tissues of your body. The respiratory (breathing) system also removes carbon dioxide from your blood. When you exhale, you release this carbon dioxide from your body. When either of these processes fails, respiratory failure can occur.

Respiratory failure may be acute or chronic.

Acute respiratory failure is short term and chronic respiratory failure is long term. Acute respiratory failure happens suddenly and is treated as a medical emergency. Chronic respiratory failure develops over a longer amount of time and requires long-term treatment.

Chronic respiratory failure can also be classified as hypoxemic or hypercapnic respiratory failure. Low blood oxygen levels cause hypoxemic respiratory failure. High carbon dioxide levels cause hypercapnic respiratory failure.

Causes of Chronic Respiratory Failure

Certain respiratory diseases can cause chronic respiratory failure. Conditions that affect the way in which muscles, nerves, bones, or tissues support breathing can also cause respiratory failure.

These include:

  • COPD (chronic obstructive pulmonary disease)
  • spinal cord injuries
  • nerve damage (involving the nerves that controls breathing)
  • chronic alcohol abuse suppresses the respiratory center

Some of these conditions affect the lungs directly and some affect the way the brain controls the lungs.

Recognizing the Symptoms of Chronic Respiratory Failure

Symptoms of chronic respiratory failure may not be apparent right away. They usually occur slowly over time and include:

  • difficulty breathing
  • bluish tint to the skin or lips (due to oxygen deprivation)
  • bluish fingernails
  • rapid breathing
  • fatigue
  • agitation, anxiety, confusion or sleepiness

Severe respiratory failure may cause a person to slip into a coma or develop an abnormal heart rhythm.

Diagnosing Chronic Respiratory Failure

Based on your symptoms, medical history, and a physical exam, your doctor will be able to diagnose chronic respiratory failure.

Medical History

Your doctor will ask questions about diseases you might have now or have had in the past to learn more about your medical history. Certain diseases can lead to respiratory failure, so these answers are beneficial.

Physical Examination

During a physical exam, your doctor will listen for abnormal sounds in your lungs and heart using a stethoscope.

Pulse Oximetry Test

The doctor will measure your oxygen level using a small sensor that’s placed on the tip of your finger to see if you are getting enough oxygen. This is called the pulse oximetry test. In healthy patients, normal oxygen saturation will be 96 to100 percent. A low percentage, under 90 percent, indicates a abnormal or low oxygen level.

Arterial Blood Gas Test

The arterial blood gas test is a test used to check the level of oxygen and carbon dioxide in your blood. A doctor or nurse will take blood from the artery in your wrist. Then, they will send the blood to a lab for testing. The results of this test indicate the amount of oxygen and carbon dioxide in your blood.

Imaging Tests

Your doctor can use a chest X-ray or CT (computerized tomography) scan to obtain a better view of your lungs. These tests reveal possible causes of chronic respiratory failure.

Treating Chronic Respiratory Failure

Although acute respiratory failure is a medical emergency that must be treated in a hospital, chronic respiratory failure can be treated at home. In severe cases, medical professionals can help you manage it in a long-term health care center.

Treatment options typically include:

  • treating the cause of the respiratory failure
  • removing excess carbon dioxide from your bod
  • increasing your blood oxygen levels

Oxygen Therapy

If you don’t have enough oxygen in your blood, you may receive oxygen therapy. Oxygen therapy increases oxygen in your blood by increasing the amount you inhale. Oxygen travels through a tube, from an oxygen machine. The other end of the tube is connected to a mask that you wear over your mouth and nose. There are oxygen machines small enough to be portable and can be carried a shoulder bag.

Tracheotomy

In severe cases, you may need a tracheotomy. The doctor creates a small hole in the front of your neck where your windpipe is located. An open tube is placed in the hole to help you breathe.

Ventilation Machine

If the above methods aren’t an option or if the respiratory failure does not improve, your doctor will put you on a ventilation or breathing machine. The machine pumps oxygen through a tube that fits on a mask over your mouth and nose. Instead of you having to breathe in the air manually, the machine blows it into your nose and mouth.

Potential Long-Term Complications of Chronic Respiratory Failure

If you have a long-term disease such as COPD or lung emphysema, you may need long-term help with your breathing. The overall outlook depends on the exact cause of the respiratory failure, your health in general, and when you received treatment. There aren’t any guaranteed prevention methods or cures for this condition.

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