Lung failure, also known as respiratory failure, is a condition in which the lungs cannot adequately perform their function. This occurs when the respiratory system fails to either get enough oxygen into the bloodstream or remove enough carbon dioxide from it. Both oxygen and carbon dioxide levels in the blood must remain within a healthy range for the body’s organs to function correctly. When this gas exchange is impaired, it can affect the brain, heart, and other organs, requiring immediate medical attention.
Understanding Different Types
Lung failure is classified into two main types based on the gas exchange problem. Type 1, or hypoxemic respiratory failure, involves low blood oxygen (hypoxemia). In this type, carbon dioxide levels may be normal or even low. It typically arises from conditions that hinder the transfer of oxygen from the lungs into the bloodstream, such as damage to lung tissue.
Type 2, or hypercapnic respiratory failure, occurs when the lungs cannot adequately remove carbon dioxide, leading to high levels of carbon dioxide in the blood, known as hypercapnia. While high carbon dioxide is the defining feature, low oxygen levels are also often present. This type commonly results from issues that reduce the overall ventilation of the lungs, affecting both oxygen intake and carbon dioxide removal.
Lung failure can also be categorized by onset: acute or chronic. Acute lung failure develops suddenly and can be rapidly life-threatening, often requiring emergency treatment. Chronic lung failure, in contrast, develops gradually, with symptoms appearing slowly. While less dramatic, chronic forms still require ongoing management and can be severe.
What Leads to Lung Failure
Many conditions can impair the lungs’ ability to exchange gases, leading to lung failure. Problems affecting the airways, the air tubes of the lungs, can cause this condition. Examples include chronic obstructive pulmonary disease (COPD) and severe asthma, where narrowed or blocked airways make breathing difficult. These conditions can trap air and mucus, limiting gas flow.
Diseases that damage the lung tissue also contribute. Pneumonia, an infection of the air sacs, or acute respiratory distress syndrome (ARDS), a severe lung injury, can cause fluid buildup or scarring, preventing effective oxygen absorption. Pulmonary fibrosis, where lung tissue becomes scarred and stiff, also impedes gas exchange.
Issues with the blood vessels in the lungs can also lead to it. A pulmonary embolism, a blood clot blocking a lung artery, prevents blood from picking up oxygen. Conditions affecting the heart, such as congestive heart failure, can cause fluid to back up into the lungs, leading to pulmonary edema and hindering gas exchange.
Problems with the nerves and muscles controlling breathing can result in it. Neuromuscular disorders like muscular dystrophy, amyotrophic lateral sclerosis (ALS), or spinal cord injuries can weaken the breathing muscles, making effective breathing difficult. Drug overdose can also suppress the brain’s control over breathing, causing inadequate ventilation.
Recognizing the Signs
Recognizing the signs of lung failure is important for timely medical help. One common symptom is severe shortness of breath, or dyspnea, a feeling of not getting enough air. This can be accompanied by rapid, shallow breathing as the body compensates for inadequate gas exchange.
Bluish skin, lips, or nail beds (cyanosis) indicate low blood oxygen. This reflects insufficient oxygen reaching tissues. Headaches, blurred vision, and excessive sweating can also occur from blood gas imbalances.
When oxygen or carbon dioxide levels are abnormal, the brain can be affected. This can lead to confusion, drowsiness, or altered mental state. In severe cases, consciousness may be lost. A rapid heart rate is common as the heart pumps more blood to compensate for insufficient oxygen delivery. These symptoms indicate a medical situation requiring immediate professional assessment.
Treatment and Management
Treatment for lung failure is tailored to its cause and type, with goals of improving oxygen and removing excess carbon dioxide. Oxygen therapy is a common approach, providing supplemental oxygen through a nasal cannula or a mask to increase available oxygen. This ensures organs receive sufficient oxygen.
For more severe cases, mechanical ventilation may be necessary. A ventilator supports or takes over the work of breathing by moving air into and out of the lungs. This can involve a tube inserted into the airways or non-invasive methods like masks that deliver air pressure. Extracorporeal membrane oxygenation (ECMO) is an advanced option for severe breathing problems, where a machine acts as an artificial lung.
Addressing the underlying cause of lung failure is central to treatment. This might involve administering antibiotics for infections like pneumonia, bronchodilators to open airways in conditions such as asthma or COPD, or diuretics to reduce fluid buildup in the lungs from heart failure. Supportive care, including nutrition and managing complications, is also provided to help the patient recover. Acute lung failure often requires intensive care, while chronic forms may be managed at home with medical oversight.