We breathe oxygen from the air into our lungs, and we breathe out carbon dioxide, which is formed in our body as a waste gas. Breathing is essential to life itself. Oxygen must pass from our lungs into our blood for our tissues and organs to work properly.
Respiratory failure is a serious condition that develops when the lungs can’t get enough oxygen into the blood. Buildup of carbon dioxide can also damage the tissues and organs and further impair oxygenation of blood and, as a result, slow oxygen delivery to the tissues.
Acute respiratory failure happens quickly and without much warning. It is often caused by a disease or injury that affects your breathing, such as pneumonia, opioid overdose, stroke, or a lung or spinal cord injury. Acute respiratory failure requires emergency treatment. Call 9-1-1 if you suddenly experience trouble breathing, feel confused, or if your family and/or caregivers notice a bluish color on your skin or lips.
Respiratory failure can also develop slowly. When it does, it is called chronic respiratory failure. Symptoms include shortness of breath or feeling like you can’t get enough air, fatigue (extreme tiredness), an inability to exercise as you did before, and sleepiness.
A doctor may diagnose you with respiratory failure based on the oxygen and carbon dioxide levels in your blood, how fast and shallow your breathing is, the results of lung function tests, and other aspects, such as how hard you are working to breathe.
If you are diagnosed with a serious lung disease, you may need extra oxygen through tubes in your nose or support with a breathing machine called a ventilator.
Explore this Health Topic to learn more about respiratory failure, our role in research and clinical trials, and where to find more information.
Any condition or injury that affects breathing can cause respiratory failure. The condition or injury may affect your airways or lungs. Or it may affect the muscles, nerves, and bones that help you breathe.
When you can't breathe well, your lungs can’t easily move oxygen into your blood or remove carbon dioxide. This causes a low oxygen or high carbon dioxide level in your blood. Learn more about how your lungs normally exchange oxygen and carbon dioxide in this video.
Respiratory failure can be caused by:
You may have an increased risk of respiratory failure because of your age, environment or occupation, lifestyle habits, and other medical conditions or medicines and procedures.
Premature babies who have neonatal respiratory distress due to an under-developed lung, pulmonary hypertension, or certain lung birth defects have a higher risk of respiratory failure. Older adults have more risk factors for respiratory failure. It is more likely that food will accidentally go down the windpipe instead of the food pipe or that a cold will lead to a severe chest infection. Older adults are also more likely to have muscle weakness that can affect breathing.
Breathing in lung irritants can lead to lung damage over the long term and put you at risk of serious lung diseases. You may breathe in these irritants from the air where you live or work.
Lung irritants include air pollution, chemical fumes, asbestos, aniline dyes and paints, dust, and secondhand smoke (smoke in the air from other people smoking).
You may have a greater risk of respiratory failure if you have certain medical conditions or injuries.
Many other serious health conditions can also raise your risk. This includes coronary heart disease, kidney or liver disease, or a weakened immune system.
Smoking can cause lung diseases that raise your risk of respiratory failure.
Using drugs or alcohol raises your risk of an overdose. A drug or alcohol overdose affects the area of the brain that controls breathing. During an overdose, breathing becomes slow and shallow, and this can cause acute respiratory failure. This can happen from using illegal drugs or misusing prescription opioid painkillers.
Certain sedatives used during surgery affect your breathing. This can put you at risk of respiratory failure, especially if you have other risk factors.
Complications from major surgery can also raise your risk of respiratory failure.
If you have a condition that puts you at risk of respiratory failure, talk to your doctor. He or she can ask questions and do a physical exam to look for issues that may put you at risk of getting respiratory failure in the future. Your doctor can also talk to you about how to manage your condition to prevent respiratory failure. He or she can also screen you if you have a planned surgery.
There are things you can do to keep your lungs healthy, including quitting or not smoking, limiting alcohol, and not misusing opioids or taking illegal drugs. Learn about additional ways to keep your lungs healthy in our How the Lungs Work Health Topic.
Your doctor may also talk to you about other healthy lifestyle changes that can help lower your risk. This may include being physically active, choosing a diet such as the DASH eating plan, aiming for a healthy weight, managing stress, and getting good-quality sleep.
Symptoms of respiratory failure depend on its cause, the levels of oxygen and carbon dioxide in your blood, and whether respiratory failure developed slowly over time or suddenly. You may start out with mild symptoms such as shortness of breath or rapid breathing, which may get worse over time. Acute respiratory failure can be a life-threatening emergency. Respiratory failure may cause damage to your lungs and other organs, so it is important to get treated quickly.
Low oxygen levels in your blood can cause:
High carbon dioxide levels in your blood can cause:
You can have symptoms of low oxygen and high carbon dioxide at the same time. Some people who have respiratory failure become extremely sleepy or lose consciousness if their brain does not get enough oxygen or if carbon dioxide levels are very high.
Symptoms of respiratory failure in newborns include rapid breathing, grunting, widening of the nostrils with each breath, a bluish tone to your baby's skin and lips, and a pulling inward of the muscles between the ribs between the ribs while breathing.
Respiratory failure can cause serious or life-threatening problems such as:
Your doctor will check your medical history, perform a physical exam, and do tests and procedures to diagnose respiratory failure.
Your doctor will ask you or your family members about your medical history and risk factors, especially any medical conditions that may affect your lungs and breathing. Your doctor will also ask if you have any symptoms of respiratory failure such as shortness of breath, rapid breathing, and confusion.
During a physical exam your doctor may do the following:
Diagnostic tests and procedures
To diagnose respiratory failure, your doctor may order some of the following tests and procedures.
Acute respiratory failure can be life-threatening and may need a quick diagnosis and emergency medical treatment in a hospital. Emergency treatment can help quickly improve your breathing and provide oxygen to your body to help prevent organ damage. Your healthcare team will then treat the cause of your respiratory failure. Treatments for respiratory failure may include oxygen therapy, medicines, and procedures to help your lungs rest and heal.
Chronic respiratory failure can often be treated at home. If you have serious chronic respiratory failure, you may need treatment in a long-term care center.
If you have respiratory failure, you may receive oxygen therapy. There are different ways to get the oxygen into your lungs, depending on how severe your respiratory failure is.
Your doctor may prescribe medicines to improve your symptoms or treat the cause of your respiratory failure. These may include:
If you have to stay in the hospital for a while, you may need treatments to avoid or manage other conditions or complications.
For both acute (short-term) and chronic (long-term) respiratory failure, it is important to follow your treatment plan, manage your condition, and know when you should seek medical care. You may need pulmonary rehabilitation to help your lungs work better.
Your oxygen and carbon dioxide levels may take a while to return to a healthy range. Because of this, you may continue to have shortness of breath or other symptoms for a few weeks or longer. You may need to do daily activities more slowly.
Using a mechanical ventilator for a long time may hurt your lungs and windpipe. You may need follow-up care for these complications. As you recover at home, watch to see if they develop.
If you have chronic respiratory failure, you will likely need ongoing care. Ask your doctor how often you will need it. You may also have to carry a portable oxygen cannula and tank with you.
For either acute or chronic respiratory failure, your doctor may refer you to pulmonary rehabilitation. This is an exercise training, education, and counselling program that can help your lungs work better.
Your doctor may talk to you about ways to prevent complications in the future, especially if you have chronic respiratory failure.
For more information about keeping your lungs healthy, visit our How the Lungs Work Health Topic.
If you have chronic respiratory failure, your symptoms may suddenly get worse. Call 9-1-1 for help if you suddenly have trouble breathing or talking.
Keep phone numbers handy for your doctor, the hospital, and someone who can take you for medical care. You should also have directions to the doctor's office and hospital and a list of all the medicines you're taking on hand.
Living with chronic respiratory failure may cause fear, anxiety, depression, and stress. Talk about how you feel with your healthcare team or a professional counselor. They can help you find or learn ways to cope.
We lead or sponsor many studies on respiratory failure. See if you or someone you know is eligible to participate in our clinical trials.
After reading our Respiratory Failure Health Topic, you may be interested in additional information found in the following resources.