Respiratory Failure - Treatment - Treatment

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.

Oxygen therapy

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.

  • Plastic tubes that rest in your nose, called a nasal cannula, attached to a portable oxygen tank. You may need a special system to get a higher flow of oxygen, called a high flow nasal canula.
  • Bag mask ventilation. You may wear a mask attached to a bag to get more air into your lungs. This is often done while you are waiting for a complex procedure to treat the cause of your respiratory failure.
  • Noninvasive positive pressure ventilation (NPPV). This treatment uses mild air pressure to keep your airways open while you sleep. You wear a mask or another device that fits over your nose or your nose and mouth. A tube connects the mask to a machine that blows air into the tube. Continuous positive airway pressure (CPAP) is one type of NPPV. For more information, visit the CPAP Health Topic. Although it focuses on CPAP treatment for sleep apnea, it explains how CPAP works.
  • A mechanical ventilator, if the oxygen level in your blood doesn’t increase, or if you're still having trouble breathing. A ventilator is a machine that supports breathing. It blows air—or air with increased amounts of oxygen—into your airways and then your lungs. Using a ventilator, especially for a long time, can damage your lungs and airways and cause infections such as pneumonia.
  • A tracheostomy to deliver oxygen, if your airways are blocked. A tracheostomy is a surgically made hole that goes through the front of your neck and into your windpipe. A breathing tube, also called a tracheostomy or trach tube, is placed in the hole to help you breathe.
Figure A shows a side view of the neck and the correct placement of a tracheostomy tube in the windpipe. Figure B shows an outside view of a person who has a tracheostomy.
Figure A shows a side view of the neck and the correct placement of a tracheostomy tube in the windpipe. Figure B shows an outside view of a person who has a tracheostomy.
  • Extracorporeal membrane oxygenation (ECMO). People with severe breathing problems may need ECMO. This treatment pumps your blood through an artificial lung to add oxygen and remove carbon dioxide before returning the blood to your body. It may be used for several days or weeks to give the lungs a chance to recover. Some complications of ECMO are blood clots, bleeding, and infections, all of which can be life-threatening.

Medicines

Your doctor may prescribe medicines to improve your symptoms or treat the cause of your respiratory failure. These may include:

  • Antibiotics to treat bacterial lung infections such as pneumonia.
  • Bronchodilators to open your airways or treat an asthma attack.
  • Corticosteroids to shrink swollen airways and treat any inflammation.

Other treatments

If you have to stay in the hospital for a while, you may need treatments to avoid or manage other conditions or complications.

  • Fluids. You may be given fluids to improve blood flow throughout your body. Fluids are usually given through an intravenous (IV) line inserted in one of your blood vessels.
  • Nutritional support. You may need a feeding tube to make sure you get enough of the right nutrients while you are on a ventilator.
  • Physical therapy. This can help maintain muscle strength and prevent sores from forming. Movement may also help shorten the time you are on a ventilator and improve recovery after you leave the hospital.
  • Positioning your body. For severe respiratory failure, your doctor may recommend that you spend most of the time lying facedown, which helps oxygen get to more of your lungs.
  • Pulmonary rehabilitation. This program of education and exercise teaches you breathing techniques that can improve your oxygen levels.
  • Blood-thinning medicine. If you are very sick or got sick very quickly, this medicine can prevent blood clots from forming. If you cannot use a blood thinner for some reason, your doctor may order special stockings or devices to increase the pressure on your legs.