Chronic Respiratory Failure in Adults

Chronic respiratory diseases (CRD) can bring a heap of trouble. In 2017, over 544 million people around the world had CRD, which is an increase of 39.8% compared to the data recorded in 1990. These ailments were the 3rd main cause of death in 2017.

A problem with any of these diseases could cause respiratory failure. Spotting the issue can help mitigate the symptoms. It’s a good idea to know how to recognize the chronic respiratory symptoms and understand the complications that come with it. This is a detailed analysis of respiratory failure in adults.

Chronic Respiratory Failure – Covering the Basics

Respiratory failure is a clinical condition that occurs the moment the respiratory system is incapable of maintaining its primary function – gas exchange. As a result, PaO2 (a measurement of oxygen pressure in arterial blood) is less than 60 mmHg.

And/or PaCO2 (partial pressure of carbon dioxide) is well over 50 mmHg. In other words, a condition in which the lungs have trouble getting rid of the carbon dioxide (CO2) or supplying the blood with oxygen (O2). This can leave the body high in CO2, low in O2, or both.

Respiratory failure is also classified based on its duration, course, and onset into chronic, acute, and acute on top of chronic respiratory failure. Acute begins fast and lasts a short time. Whereas chronic respiratory failure develops slowly and over time. Chronic respiratory failure is an ongoing problem that needs long-term treatment.

This condition is also classified based on blood gas abnormalities into type 1 and type 2. Type 1 (hypoxemic) respiratory failure 1 interferes with the lung’s capability to oxygenate the blood. While Type 2 (hypercapnic) causes a drop in respiratory muscle power and respiratory drive. These respiratory failure types will indicate the level of impact this condition has on the body.

What Happens When You Have Chronic Respiratory Failure?

What are the signs of respiratory failure? The chronic respiratory symptoms will vary based on the oxygen and carbon dioxide levels in the blood. Including what’s causing the problem. When the oxygen drops too low, people might feel that they can’t inhale enough air. This causes labored breathing.

Some people also develop a bluish color on their fingernails, lips, and skin. With skyrocketing carbon dioxide levels, patients are confused and have rapid breathing. Those who develop irregular heartbeat (arrhythmia) may feel as though they are losing consciousness. And are feeling very sleepy. These signs can occur if the heart and central nervous system are lacking oxygen.

Overall, you can develop some of the following signs:

• Exhaustion
• Rapid breathing
• Daily headaches
• Blue tint to the fingernails, lips, or skin
• Wheezing
• Mucus when coughing
• Trouble breathing
• Shortness of breath (particularly when exercising)

Chronic respiratory failure is not to be underestimated. This is a serious ailment that can get worse with time. Patients could stop breathing, have an irregular heartbeat, or slip into a coma.

Complications may lead to lung issues like pulmonary embolism or ventilator dependence. As well as cardiac problems i.e. cardiac arrest or acute myocardial infarction. Or neurological complications, for example, prolonged brain hypoxia.

Causes

A plethora of chronic respiratory failure causes exist. Some lung ailments can trigger this condition. At times, it could be the result of an injury or excessive smoking. Anything that has a drastic impact on the lungs or airways can prompt this problem. The typical causes include:

• Smoking, alcohol, or drug misuse
• Injury to the spinal cord or chest
• Pneumonia complications
• Stroke
• COPD (Chronic obstructive pulmonary disease)
• Cystic fibrosis
• ALS (Lou Gehrig’s disease)
• Muscular dystrophy

How Long Does Chronic Respiratory Failure Last?

Patients with chronic respiratory failure often require mechanical ventilation for more than 28 days. But, the duration can vary from person to person. Unlike acute respiratory failure, chronic ailment means an ongoing condition. So, it needs consistent treatment.

Can You Recover from Chronic Respiratory Failure?

There isn’t a cure available for this type of condition. However, its signs and impact could be managed with adequate chronic respiratory failure treatment. The main goal when mitigating this problem is to enhance the carbon dioxide or oxygen levels. In chronic cases, doctors may suggest:

• Sleep support – When the airways are blocked during sleep, a machine can keep breathing in check. The mask is designed to push air into the airways so that the patient maintains healthy oxygen and carbon dioxide levels. It’s best to find a comfortable sleeping position to make breathing easier.
• Home oxygen therapy – Patients are given small units, like a tank or machine they can use at home to breathe in oxygen. These patients might need to use the unit only when exercising or 24 h/day.
• Mechanical ventilation – When breathing is extremely weakened, experts recommend mechanical ventilation. It applies a positive pressure breath and ensures that an adequate volume of air enters the lungs. Only a doctor can suggest the best form of treatment.

Diagnosis

If you are at risk of developing the condition or experiencing any of the underlying symptoms, then the doctor will perform a physical exam and talk about your medical history. They will run a couple of tests to diagnose the problem. These may include:

• Pulse oximetry test – Meant to assess the oxygen levels. Healthy people have somewhere between 96% to 100% oxygen saturation range. For those with an oxygen level below 90%, the readings indicate an abnormality.
• Imaging tests – In case the lungs may be affected, doctors suggest a CT scan or X-ray.
• Arterial blood gas test – A small amount of blood is drawn to examine arterial gasses.
• Bronchoscopy – When a lung tissue or airway sample is needed, the doctor will insert a flexible, thin instrument called a bronchoscope into the lungs and airway.

Prevention

Although you can’t prevent a chronic respiratory failure from a chest or spinal cord injury, you can still take the necessary precautions to keep your lungs in tip-top shape. Experts explain that managing your current health issue should be a top priority.

If you are struggling with COPD or cystic fibrosis, which can amplify your risk of chronic respiratory failure, it’s critical to stick to your treatment plan. Keep the lungs and airways clean by avoiding cigarette smoking.

Cigarette smokers are 22 times more likely to develop lung carcinoma compared to nonsmokers. Tobacco smoking is the reason for more than 90% of lung cancer in regions where smoking is highly prevalent. Also, try to limit your alcohol use and avoid misusing drugs.

It’s a good idea to implement healthy lifestyle habits. Such as managing your daily stress, eating nutritious and versatile food, getting enough shut-eye, and striving to curb the excess body weight. With options such as these, you can take good care of your lungs.

Final Thoughts

Living with long-term (chronic) respiratory failure can take a toll on your psychological and physical well-being. But, with ailments such as these, it’s essential that you stick to your recommended treatment plan. Doctors can help you mitigate the problem. Whenever you spot the issue, seek medical care.

Some patients might require pulmonary rehab to restore full lung function. But, the treatment will vary based on the severity and impact of the condition. Those who need ongoing care will consult with their doctor on a regular basis. Sometimes, they might need to use a portable oxygen tank to get the desired result.