Respiratory failure is a serious medical condition in which the gas exchange which normally takes place in the lungs is disrupted. As a result, the patient may have low oxygen in the blood, or high carbon dioxide levels, or both, depending on what is causing the respiratory failure. This condition requires medical attention, as patients can die as a result of respiratory failure.
The pathophysiology of respiratory failure can be quite variable. In some cases, it involves damage or injury to the lungs, ranging from cancer to a chest wall injury which causes a lung to collapse. Obstruction of the airways can also be a cause. Cardiac dysfunction can also lead to respiratory failure, as the heart may not pump blood well enough for gas exchange to take place. Problems with the areas of the brain which manage respiration can also lead to respiratory failure.
In hypoxemic failure, the patient's blood is not sufficiently oxygenated. Hypercapnic forms involve too much carbon dioxide in the blood, indicating that the patient is not able to expel carbon dioxide. It is also possible for both conditions to be present. Patients may have acute respiratory failure, in which the condition onsets very rapidly, or a chronic form, which takes place over an extended period of time. People with chronic forms may not realize what is going on, as their bodies will adapt over time.
Treatment of this condition requires that the cause be determined and addressed. If a patient is in immediate distress, mechanical ventilation may be used to supply the patient with oxygen and to keep the systems of the body functioning while diagnostic tests are performed to find out why the patient's respiratory system is not working as it would normally. Acute respiratory failure may require hospitalization even if the patient does not need mechanical ventilation.
A patient can go into respiratory arrest and stop breathing altogether, which is a very dangerous and undesirable situation. Medical professionals usually try to manage respiratory failure so that a patient does not go into full arrest. Even with treatment, patients can die from this condition, because it may not be possible to manage the cause. Respiratory failure can also occur during the end stages of disease, in which case a patient may not want to pursue aggressive treatment in the interests of having a more dignified death. For example, a patient may specify that she or he does not want to be on a ventilator.