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Respiratory Failure

Respiratory Failure

What is Chronic Respiratory Failure?

Chronic respiratory failure is the inability to carry out the fundamental functions of respiration. The lungs function to deliver oxygen to the blood while eliminating carbon dioxide from the blood. It is a condition that usually occurs from narrow or damaged airways that develop gradually over time with a progressive underlying process that requires long-term treatment.

Causes of Chronic Respiratory Failure

Conditions and diseases that affect your breathing can cause chronic respiratory failure and may include:

  • Pneumonia
  • Chronic obstructive pulmonary disease (COPD)
  • Smoking
  • Drug or alcohol abuse
  • Chest injury
  • Cystic fibrosis
  • Muscular dystrophy
  • Lou Gehrig’s disease (ALS)
  • Stroke
  • Spinal cord complications

Symptoms Associated with Chronic Respiratory Failure

Symptoms of chronic respiratory failure develop over an extended period of time and may include:

  • Coughing
  • Wheezing
  • Shortness of breath
  • Fast breathing
  • Headache
  • Anxiety
  • Fatigue
  • Confusion
  • Bluish coloration of the lips, fingernails, or skin
  • Abnormal heart rhythm

Diagnosis of Chronic Respiratory Failure

Your healthcare provider will be able to diagnose chronic respiratory failure based on:

  • Your medical history and symptoms
  • Your physical examination, which includes looking for signs of bluish coloration of the skin, fingernails, and lips; listening to your lungs to check for abnormal sounds; and listening to your heart to check for irregular or abnormal heart rhythm.
  • Pulse oximetry test, which is conducted to evaluate how well oxygen is being delivered to various parts of the body. Normal oxygen saturation will range anywhere between 96 to 100 percent, and anything under 90 percent would indicate an abnormally low level of oxygen.
  • Arterial blood gas test, which is conducted to measure the amount of oxygen and carbon dioxide in your blood and any abnormal level would indicate chronic respiratory failure.
  • Imaging tests, such as chest x-ray or CT scan, to get a better view of your lungs, which may reveal potential causes of chronic respiratory failure.
  • Bronchoscopy, a thin and flexible lighted instrument that is inserted into your airway and lungs to have a closer look at the lung passages as well as take samples of lung tissue and airway.

How is Chronic Respiratory Failure Treated? 

One of the main objectives of the treatment is to get oxygen to your lungs and other organs and remove carbon dioxide from your body. The common treatment options used to achieve these may include:

  • Ventilator: A breathing machine that pumps oxygen into your lungs and removes carbon dioxide from your lungs through a tube placed into your nose or mouth down into your windpipe.
  • Oxygen therapy: This therapy raises oxygen levels by increasing the amount of oxygen you inhale by delivering oxygen from a portable tank through a facemask or nasal tube, or a larger tube inserted directly into your windpipe. 
  • Tracheostomy: A surgical procedure where a hole is made through the front of your neck and into your windpipe for a breathing tube to pass through to help you breathe.
  • Other breathing treatments: Such as noninvasive positive pressure ventilation (NPPV), where mild air pressure is used to keep your airways open while you are asleep. Noninvasive ventilation includes BiPAP as well as CPAP.
  • IV fluids to improve blood flow throughout your body and medicines for discomfort.

Prognosis of Chronic Respiratory Failure

There is no permanent solution for chronic respiratory failure, however, symptoms can be handled by continuous long-term breathing treatments prescribed by your healthcare provider and diligently following the provided prescriptions.