Respiratory failure (shortness of breath)

Chest | Pulmonology | Respiratory failure (shortness of breath) (Disease)


Respiratory failure is the inability of cardiac and pulmonary systems to maintain an adequate exchange of oxygen and carbon dioxide in the lungs. This identifies it as failure of the respiratory system to meet both the bodys metabolic demand for oxygen and the clearance of carbon dioxide (metabolic waste).

Type 1 respiratory failure is defined as hypoxia without hypercapnia, and indeed the PaCO2 may be normal or low. It is typically caused by a ventilation/perfusion (V/Q) mismatch. Type 2 respiratory failure is caused by inadequate ventilation; both oxygen and carbon dioxide are affected. Defined as the build up of carbon dioxide levels (PaCO2) that has been generated by the body.

Causes and Risk factors

Many pathologies can cause respiratory failure, but failure is a problem of either oxygenation or ventilation. Diseases that increase the fluid barrier in alveoli or interstitial tissues (such as pulmonary oedema, emphysema) can cause oxygenation failure. It can also be caused by: severe acute asthma, left ventricular failure and other causes of pulmonary oedema, pulmonary embolism, pneumonia.

Diagnosis and Treatment

The goals of treatment for respiratory failure are to increase oxygenation and improve ventilation. Treatment depends on the severity of the respiratory failure and the cause. Acute respiratory failure treatment will address the underlying cause and include ventilation and oxygenation as needed. Treatment for chronic respiratory failure may be administered at home. Exacerbation of chronic respiratory failure by infection may require hospitalization, and treatment may include oxygenation and ventilator support.