As chronic respiratory failure progresses, you may have symptoms such as difficulty breathing. It’s serious, and the underlying cause doesn’t always have a cure. However, treatments are available to help you manage the symptoms.
Respiratory failure can occur when your respiratory system is unable to remove enough carbon dioxide from your blood, causing it to build up in your body. The condition can also occur when your respiratory system can’t take in enough oxygen, leading to dangerously low levels of oxygen in your blood.
Respiratory failure may be acute or chronic.
Acute respiratory failure is a short-term condition. It occurs suddenly and is typically treated as a medical emergency. Chronic respiratory failure is an ongoing condition. It develops gradually and requires long-term treatment.
Chronic respiratory failure usually happens when the airways that carry air to your lungs become narrow and damaged. This limits the movement of air throughout your body, which means that less oxygen gets in and less carbon dioxide gets out.
Did you know?
Chronic respiratory failure can also be classified as hypercapnic or hypoxemic respiratory failure.
High blood levels of carbon dioxide cause hypercapnic respiratory failure. Low blood oxygen levels cause hypoxemic respiratory failure.
Symptoms of chronic respiratory failure may not be noticeable at first. They usually occur slowly over an extended period of time.
When symptoms do develop, they may include:
- difficulty breathing or shortness of breath, especially when you’re active
- rapid breathing
- coughing up mucus
- a bluish tint to the skin, lips, or fingernails
- frequent headaches
Chronic respiratory failure is a serious illness that gets worse over time. As the condition becomes more severe, you may develop an abnormal heart rhythm, stop breathing, or slip into a coma.
Certain lung diseases can cause chronic respiratory failure. Conditions that affect how the brain, muscles, bones, or surrounding tissues support breathing can also cause chronic respiratory failure.
Diseases and conditions that commonly lead to chronic respiratory failure include:
- chronic obstructive pulmonary disease (COPD)
- complicated pneumonia
- obesity hypoventilation syndrome, a type of breathing disorder that’s associated with low blood oxygen levels
- cystic fibrosis
- injury to the chest
- spinal cord injuries
- muscular dystrophy
- amyotrophic lateral sclerosis (ALS), better known as Lou Gehrig’s disease
- drug or alcohol misuse
Smoking is another possible cause.
A doctor will be able to diagnose chronic respiratory failure by performing a physical exam and asking about your symptoms and medical history. They may also run certain tests to confirm the diagnosis.
Often an ongoing illness or significant injury has occurred prior to the development of chronic respiratory failure.
During a physical exam, the doctor will use a stethoscope to listen for unusual sounds in your lungs and heart.
The doctor will ask you about lung diseases or conditions you currently have or have had in the past.
Pulse oximetry test
Pulse oximetry is a simple and painless test that evaluates how well oxygen is being sent to various parts of the body.
The doctor will place a small sensor on the tip of your finger or ear lobe to determine whether you’re getting enough oxygen.
In healthy people, the normal oxygen saturation range will be between 95% and 100%, according to StatPearls. The American Thoracic Society states that any percentage under 89% indicates an abnormally low oxygen level.
Arterial blood gas test
An arterial blood gas test is a safe and easy procedure that measures the amount of carbon dioxide and oxygen in your blood. It also measures the pH, or acidity level, of your blood.
The doctor will draw blood from an artery in your wrist. They’ll then send the blood to a lab for analysis. The results of this test indicate carbon dioxide and oxygen levels in your blood as well as its overall chemistry.
The doctor can use a chest X-ray or CT scan to obtain a better view of your lungs.
A bronchoscope is a thin, flexible lighted instrument that can be inserted into your lungs and airways. Doctors can use bronchoscopy to get a closer look at the lung passages as well as to take samples of airway and lung tissue.
Although acute respiratory failure is a medical emergency that must be treated in a hospital, chronic respiratory failure can be managed at home, depending on its cause.
In severe cases, medical professionals can help you manage the condition in a long-term healthcare center.
Treatment options typically include:
- addressing the underlying cause of your respiratory failure (perhaps with medications)
- removing excess carbon dioxide from the blood
- increasing oxygen levels in the blood
Some treatments are detailed below.
You may receive oxygen therapy if you don’t have enough oxygen in your blood. Oxygen therapy raises your oxygen levels by increasing the amount of oxygen you inhale.
Oxygen is distributed from a tank through a tube. The gas enters your lungs through a face mask, nasal tubes, or one larger tube directly inserted into your windpipe. There are small, portable oxygen machines that you can carry in a shoulder bag.
In severe cases of chronic respiratory failure, you may need a tracheostomy. During this procedure, a surgeon places a tube in your windpipe so you can breathe more easily.
The tube is inserted through a cut in the front of your neck where your windpipe is located. This tube can be temporary or permanent.
If chronic respiratory failure doesn’t improve with other treatments, the doctor may put you on a ventilator, or breathing machine.
This machine pumps oxygen through a tube that’s inserted into your mouth or nose and extends down into your windpipe. Since the ventilator blows air directly into your lungs, you don’t have to work as hard to breathe oxygen in on your own.
Depending on the severity of your condition, you may only need the ventilator to help you with breathing, or you may need the ventilator to do all of the breathing for you.
Other forms of breathing assistance, known as noninvasive ventilation (NIV), include bilevel positive airway pressure (BiPAP) and continuous positive airway pressure (CPAP) machines. These may be appropriate long-term options for people with certain conditions, like COPD.
There often isn’t any cure for chronic respiratory failure, but you can manage your symptoms with treatment.
Your specific outlook depends on the exact cause of your respiratory failure, your overall health, and how quickly you receive treatment. If you have a chronic lung disease, you may need continuous help with your breathing.
Speak with a doctor to learn more about the outlook for your particular case.