Acute Respiratory Failure (Adult)

Acute respiratory failure is when one or both of these things happen:

Oxygen cannot pass from the lungs into the blood, causing the blood oxygen level to drop. Loss of blood oxygen means tissues and organs may not work well.
A gas called carbon dioxide cannot pass from the blood into the lungs so the body can get rid of it. The buildup of carbon dioxide can damage the tissues and organs in the body.

Acute respiratory failure happens fast. It is an emergency and needs to be treated right away.

What are the causes?

Common causes of respiratory failure that may cause low oxygen levels include:

Trauma to the lung, chest, or ribs, or to the tissues around the lung.
Lung conditions, such as pneumonia, asthma, or blood clots in the lungs (pulmonary embolism).
Breathing in harmful chemicals, smoke, water, or vomit.
A widespread infection (sepsis).
Heart attack.

Common causes of respiratory failure that cause a buildup of carbon dioxide include:

Stroke.
A spinal cord injury.
Drug or alcohol overdose.
Sepsis.
The heart stopping all of a sudden (cardiac arrest).

What increases the risk?

This condition is more likely to develop in people who have:

Known lung conditions, such as asthma or chronic obstructive pulmonary disease (COPD).
A condition that damages or weakens the muscles, nerves, bones, or tissues that are involved in breathing, such as myasthenia gravis or Guillain–Barré syndrome.
A health problem that blocks the unconscious reflex that is involved in breathing, such as hypothyroidism or sleep apnea.

What are the signs or symptoms?

Symptoms may depend on the cause and on the levels of oxygen and carbon dioxide in your blood.

Trouble breathing is the main symptom of acute respiratory failure.

Other symptoms may include:

Fast breathing.
Making high-pitched whistling sounds when you breathe (wheezing) and grunting.
Confusion or changes in behavior.
Feeling tired, sleeping more than normal, or being hard to wake.
Skin, lips, or fingernails that look blue (cyanosis).
Feeling restless or anxious.
Fast or irregular heartbeats (palpitations).

How is this diagnosed?

A device clipped onto a finger to measure the amount of oxygen in the blood.

This condition may be diagnosed based on:

Your medical history and a physical exam. Your health care provider will listen to your heart and lungs to check for abnormal sounds.
Tests to confirm the diagnosis and find the cause of respiratory failure. Tests may include:
- Measuring the amount of oxygen in your blood (pulse oximetry). This involves placing a small device on your finger, earlobe, or toe.
- Blood tests to measure levels of blood oxygen and carbon dioxide.
- Chest X-ray.

How is this treated?

Treatment for this condition usually takes place in a hospital intensive care unit (ICU). Treatment depends on the cause of the condition. Treatment may include one or more of these:

Oxygen given through your nose or a face mask.
A device to help you breathe, such as a continuous positive airway pressure (CPAP) machine or bilevel positive airway pressure (BIPAP) machine. The device gives you oxygen and pressure.
Other breathing treatments, fluids, and medicines.
A breathing machine called a ventilator. This gives you oxygen and pressure to help you breathe. A tube is put into your mouth and windpipe (trachea) and connects to the ventilator.
Tracheostomy placement, if you are on a ventilator for a long time. A tracheostomy is a breathing tube put through your neck into your trachea.

Follow these instructions at home:

Medicines

Take over-the-counter and prescription medicines only as told by your health care provider.
If you were prescribed antibiotics, take them as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

General instructions

Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
Keep all follow-up visits.

Contact a health care provider if:

Your symptoms do not improve or they get worse.

Get help right away if:

You are having trouble breathing.
You lose consciousness.
Your heart starts beating very fast.
Your fingers, lips, or other areas of your body turn blue.
You are confused.

These symptoms may be an emergency. Get help right away. Call 911.

Do not wait to see if the symptoms will go away.
Do not drive yourself to the hospital.

Summary

Acute respiratory failure is a condition that develops fast and needs to be treated right away.
The main symptom of this condition is trouble breathing.
Treatment for this condition usually takes place in a hospital intensive care unit (ICU). Treatment may include oxygen, fluids, and medicines. A machine may be used to help you breathe, such as a ventilator.
Contact a health care provider if your symptoms do not improve or if they get worse.