Respiratory Failure

What is respiratory failure (RF)?
Respiratory failure is when the patient is not able to breathe adequately on his/her own. This happens when the patient's pulmonary disease becomes much worse or the nerves and muscles controling breathing are not able to function due to fatigue, disease or possibly injury.

What causes respiratory failure?
RF can be caused by a number of diseases, including:

• worsening of chronic obstructive lung diseases (COPD) such as chronic bronchitis, emphysema or asthma
• congestive heart failure
• acute respiratory distress syndrome
• pneumonia
• neuromuscular disease such as Guillain-Barré syndrome, myasthenia gravis, or amyotrophic lateral sclerosis.

What are the symptoms of RF?
Patients with respiratory failure may have extreme shortness of breath, rapid and shallow breathing patterns, low oxygen blood levels, and may have higher levels of carbon dioxide in their blood.

How is RF treated?
The first step in treatment is to stabilize the patient. In acute RF, the patient is usually stabilized with artificial ventilation.

In patients who might require long-term (more than on to two weeks) artificial respiratory support, a tracheostomy may be recommended.  A tracheostomy is a surgical procedure where a small opening is made in the neck and a tube is placed through this hole into the trachea (windpipe). When the patient recovers from respiratory failure, the tube may be replaced with a smaller tube, and eventually removed. The small hole in the neck will gradually close over several weeks after the tube is removed, and the patient's voice should return normal during this time.

The second step in RF treatment is to care for the underlying cause of respiratory failure, which may be any of the conditions listed above.