Respiratory failure Home A-Z Health Information Health Library A-Z Respiratory Failure Overview Respiratory failure is a serious condition that makes it difficult to breath on your own. It develops when the lungs cannot transport enough oxygen to the blood. Causes and risk factors Respiratory failure can be manifested through pneumonia, acute respiratory distress syndrome (ARDS), pulmonary embolism, COPD, neuromuscular diseases or severe asthma flare-ups. Symptoms Respiratory failure manifests as two primary types, i.e., hypoxemic and hypercapnic.Hypoxemic respiratory failure or Type 1: Symptoms include rapid breathing, shortness of breath, cyanosis, confusion, and signs specific to the underlying cause, like fever in pneumonia. Diagnosis typically involves blood gas analysis showing low partial pressure of oxygen (PaO2) with normal or low partial pressure of carbon dioxide (PaCO2).Hypercapnic respiratory failure or Type 2: Symptoms may include slower breathing, headaches, confusion, drowsiness and eventually respiratory distress. Blood gas analysis shows elevated PaCO2 and often low PaO2 in chronic cases. Diagnosis Diagnosis of respiratory failure generally includes thorough clinical evaluation, encompassing evaluation of medical history, physical examination (lung auscultation, assessment of the respiratory rate), and imaging-based techniques like chest X-ray or CT scans to identify the underlying causes. Blood gas analysis plays a crucial role in confirming the type and severity of respiratory failure.Pulmonologists in Management extend beyond their specialised medical expertise. They provide diagnostic precision through thorough evaluations, including PFTs, imaging studies, and interpretation of diagnostic tests. Pulmonologists collaborate closely with a multidisciplinary team of healthcare professionals, including intensivists, respiratory therapists and primary care physicians, to ensure coordinated and comprehensive care throughout the duration of respiratory failure, from acute stabilisation to long-term management and palliative care as needed. Treatment Treatment of respiratory failure is a complex and multifaceted process that requires tailored approaches based on the specific type and severity of the condition. Central to this management is the role of a pulmonologist, a specialist in respiratory medicine who plays a crucial part in overseeing and coordinating the treatment plan.Oxygen Therapy is foundational in managing hypoxemic respiratory failure, where inadequate oxygenation of blood occurs. Oxygen therapy is administered through various delivery methods such as nasal cannula, face mask, or mechanical ventilation.Mechanical Ventilation becomes necessary in severe cases of respiratory failure, particularly when non-invasive methods are insufficient to support adequate gas exchange.Management of Underlying Conditions is essential as many cases of respiratory failure stem from underlying respiratory diseases such as pneumonia, COPD flare-up or ARDS. This includes prescribing antibiotics for infections, bronchodilators and corticosteroids for obstructive lung diseases, and other medications tailored to manage the specific underlying cause.Non-Invasive Ventilatory Support Strategies like BiPAP are employed for patients with hypercapnic respiratory failure, e.g., those with advanced COPD or neuromuscular diseases.Long-term management involve pulmonary rehabilitation programmes that include exercise training, education on disease management, and strategies to improve overall respiratory health. Pulmonologists also emphasise lifestyle modifications such as smoking cessation and vaccination to reduce the risk of flare-ups and disease progression.