Respiratory Failure: Causes, Symptoms, Diagnosis and Treatment

Woman with breathing difficulties. France. Credit: BSIP/UIG

Respiratory failure occurs when your lungs fail to do their job passing oxygen into your blood stream and removing carbon dioxide. It can be a complication of chronic obstructive pulmonary disease (COPD).

Your organs, muscles and other tissues need oxygen. Your lungs are responsible for bringing oxygen into your body, where it is picked up by your red blood cells and transported where it is needed.

Meanwhile, carbon dioxide — the waste gas produced by your cells as they use the oxygen — moves from your blood stream and back into your lungs, where you exhale it. This entire process is called gas exchange.

In respiratory failure, gas exchange doesn't work the way it's supposed to work, and the cells in your body start to suffer from a lack of oxygen, too much carbon dioxide, or both. Too much carbon dioxide can disrupt the acid-base balance in the body, which in itself can lead to respiratory failure.

Sudden respiratory failure is a medical emergency. If you or someone close to you can't breathe, call 911.

Causes of Respiratory Failure

Conditions that affect your ability to breathe properly can cause respiratory failure. Some possible causes of the condition include:

  • Airway obstruction
  • Head injury
  • Pneumonia
  • Asthma
  • COPD
  • Drugs, including narcotics (like morphine or vicodin) and benzodiazapines, especially when mixed with alcohol.
  • Severe obesity
  • Stroke
  • Pulmonary embolism
  • Amyotrophic lateral sclerosis (ALS)

A condition doesn't need to affect the lungs directly in order to cause respiratory failure. For example, stroke, ALS and drug/alcohol overdose all potentially can affect your nervous system's control over the nerves and muscles that in turn control your breathing.

Symptoms of Respiratory Failure

The first symptom of respiratory failure you might notice is shortness of breath — you'll feel as if you just can't take a deep breath or get enough air in your lungs. You may start breathing rapidly.

Other possible symptoms include:

  • Confusion
  • Feeling tired or fatigued
  • Lethargy (you won't have any energy)
  • Sleepiness
  • A bluish tinge to your skin

If your respiratory failure symptoms develop suddenly, you should consider them a medical emergency and seek help immediately. If your doctor has told you that you have chronic respiratory failure as a result of COPD or another chronic condition, you can receive treatment for it at home or in a long-term care facility.

Diagnosing and Treating Your Condition

If your doctor suspects respiratory failure, she may order several tests in order to diagnose you. These may include:

  • Chest x-ray
  • CT of the chest
  • Arterial blood gases (ABGs) test
  • Laboratory testing of blood and other bodily fluids

Once respiratory failure is confirmed, your treatment may include the following, depending on the cause for your condition:

  • Bronchodilators, steroids and possibly antibiotics
  • Noninvasive positive-pressure ventilation (CPAP or BiPap)
  • Oxygen therapy
  • A respirator or a non-invasive mask respirator

Once your condition is stable, your doctor will talk to you about your long-term treatment options and prognosis. Your prospects for recovery will depend on what caused your respiratory failure in the first place, how bad it was, how quickly it was treated, and your overall level of health.

Smoking causes many of the lung diseases that lead to respiratory failure. Therefore, if you smoke, you should quit immediately. Losing weight may help prevent respiratory failure, as well.


National Heart, Lung and Blood Institute. What Causes Respiratory Failure? fact sheet. Accessed Jan. 29, 2016.

National Heart, Lung and Blood Institute. What Is Respiratory Failure? fact sheet. Accessed Jan. 29, 2016.

Smeltzer, S., Bare, B. Textbook of Medical-Surgical Nursing. Lippincott. 1996.

U.S. National Library of Medicine. Respiratory Failure fact sheet. Accessed Jan. 29, 2016.

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