What is a Chronic Respiratory Failure?

Chronic respiratory failure is a condition that occurs when the lungs cannot get enough oxygen into the blood or eliminate enough carbon dioxide from the body. The main symptoms of chronic respiratory failure are trouble breathing and fatigue. Chronic respiratory failure can be caused by a variety of conditions, including chronic obstructive pulmonary disease, heart failure, pneumonia, and lung cancer.

Types of Respiratory Failure

There are several types of respiratory failure. The main types include acute, chronic, type 1, and type 2 respiratory failure.

Respiratory failure types:

• Acute respiratory failure—Occurs when there is a sudden decrease in the ability to exchange oxygen and carbon dioxide between the lungs and bloodstream.
• Chronic respiratory failure—Occurs gradually and usually requires longer-term treatment.
• Type 1 respiratory failure—Occurs when your blood oxygen level is low, but your carbon dioxide level is normal.
• Type 2 respiratory failure—Occurs when your blood oxygen level is low or normal, but your carbon dioxide level is high.

Signs & Symptoms

Chronic respiratory failure symptoms happen gradually over time. You may not recognize the symptoms in the early stages of the condition.

Chronic respiratory failure symptoms:

• Fatigue
• Confusion
• Wheezing
• Fast breathing
• Regular headache
• Breathlessness
• Bluish lips
• Bluish nails
• Bluish skin
• Coughing up phlegm

Causes

Chronic respiratory failure is caused by a variety of different conditions. 

The most common causes of respiratory failure include:

• Chronic Obstructive Pulmonary Disease (COPD)—This is a group of lung diseases that make it difficult to breathe. COPD includes conditions such as emphysema and chronic bronchitis.
• Neuromuscular Diseases—These conditions affect the muscles that help you breathe. Examples include muscular dystrophy and Lou Gehrig’s disease.
• Congenital Heart Disease—This is a heart condition that exists at birth. It can cause respiratory failure by preventing the lungs from getting enough oxygen-rich blood.
• Lung Cancer—Cancer that starts in the lungs can cause respiratory failure by blocking airways or making it difficult to breathe.
• Pneumonia—This is an infection of the lungs that can cause fluid to build up, making it difficult to breathe.
• Smoking—Smoking can lead to COPD and lung cancer, both of which can lead to respiratory failure.
• Drug Abuse—The use of certain drugs can damage the lungs and lead to respiratory failure. The misuse of prescription drugs and alcohol can also result in respiratory failure.
• Chest Injury—A severe injury to the chest can cause respiratory failure by damaging the lungs.
• Damage to the Spinal Cord—An injury to your spinal cord can affect the nerves that control the muscles used for breathing, leading to respiratory failure.

Risk Factors

There are several factors that raise your risk of developing chronic respiratory failure.

Chronic respiratory failure risk factors include:

• Choking
• Drowning
• Disease
• Illness
• Chest injury
• Head injury
• Spinal cord injury
• Nerve problems
• Lung problems

Diagnosis

To diagnose chronic respiratory failure, a healthcare professional will perform a variety of tests. 

Chronic respiratory failure diagnosis may include:

• Physical examination—This will assess your general appearance and vital signs, as well as any signs of respiratory distress.
• Review of your medical history—Your doctor will review your medical history, including any previous respiratory problems.
• Imaging tests—Imaging tests help your doctor evaluate the structure and function of your lungs. Types of imaging tests may include chest X-rays and computed tomography (CT) scans.
• Bronchoscopy—During this test, your doctor inserts a small, flexible tube with a camera into your lungs. Your doctor will usually route the tube through your nose or mouth. This test helps your doctor examine your lungs. 
• Pulmonary function tests—These tests measure how well your lungs move air and how well they exchange oxygen and carbon dioxide.
• Blood tests—Blood tests measure the levels of carbon dioxide and oxygen in your body.
• Pulse oximetry test—This test uses a small sensor placed on your finger to measure the oxygen level in your body.

Treatment

Chronic respiratory failure is either treated at home or in a health facility. Treatment for chronic respiratory failure depends on the type of respiratory failure, its cause, how severe the underlying cause is, the severity of symptoms, and your overall health.

Oxygen Therapy

Oxygen therapy is one of the most common treatments for chronic respiratory failure. In this therapy, oxygen is delivered through a nasal cannula or mask. The amount of oxygen you need will be determined by your doctor.

Tracheostomy

In some serious cases, your doctor may perform a tracheostomy. This is a surgical procedure in which your doctor makes a hole in your neck and inserts a breathing tube into your windpipe.

A tracheostomy is usually only done if other treatments have failed, and you need long-term treatment.

Fluids

Fluids are used to thin mucus and make it easier to cough up phlegm. Fluids can also help prevent dehydration, improve nutrition, and help with blood flow.

Your doctor may deliver fluids through an intravenous (IV) line.

Medicines

Medicines combine with other treatments to address chronic respiratory failure. Medicines help reduce discomfort, open airways, and to resolve blood clots.

Mechanical Ventilation

If you are unable to breathe on your own, a ventilation machine may be used to help you breathe.

This machine blows oxygen into your lungs through a tube. Depending on the seriousness of your condition, the machine may only assist you with breathing, or it may do all the work for you.

Complications

Chronic respiratory failure is a debilitating and potentially fatal condition with no known cure. You can usually treat and manage the condition in consultation with your doctor. Complications of chronic respiratory failure include heart failure, pneumonia, and pulmonary embolism. You can help prevent or mitigate complications with early diagnosis and consistent adherence to treatment. The outlook of chronic respiratory failure generally depends on the origin of your condition, the progression of your condition, and your general health.