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Respiratory failure

Also called: Respiratory failure, acute respiratory failure, chronic respiratory failure

The lungs can't get enough oxygen into the blood or can't remove enough carbon dioxide. Sudden (acute) respiratory failure is an emergency; long-term (chronic) failure is managed with oxygen and breathing support.

AcuteEmergency
ChronicHome oxygen, breathing machines
Common causesPneumonia, COPD, overdose, nerve disease

Overview

Low oxygen causes shortness of breath and blue lips. High carbon dioxide causes sleepiness and confusion.

People with COPD or nerve diseases may need a mask machine at night (BiPAP).

Symptoms

Common signs:

  • Severe trouble breathing

Less common

  • Blue lips
  • Confusion or sleepiness
  • Fast breathing

Look up a symptom: Getting winded easily with activity or stairs · New confusion or not acting like themselves

When to get medical care

Call 911Severe trouble breathing, blue lips, or very sleepy or confused: call 911.
Get care todayBreathing getting worse.
See a doctor soonMore breathless than usual with lung disease.

Causes

Lung disease, infection, overdose, nerve or muscle disease.

Does it spread or run in families?

  • It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

  • COPD
  • Neuromuscular disease
  • Opioid use

Possible complications

Diagnosis

Doctors measure oxygen and carbon dioxide.

The exam

Breathing and lung exam.

Tests

Tests, if needed:

  • Pulse oximetry:
  • Blood gas:
  • Chest X-ray:

Treatment

Get emergency care for sudden trouble.

Self-care

  • Use home oxygen exactly as prescribed
  • Keep up with vaccines
  • Don't smoke

Hospital care may include oxygen, a mask machine, or a breathing tube.

Prevention

To lower risk:

  • Flu and pneumonia vaccines
  • Don't smoke

Which doctor treats this

  • Emergency doctors treat it first, in the ER.
  • They may send you to a pulmonologist (lung doctor).

Back to school, work, or sports

  • Recovery time varies. Ask your care team when you can drive, lift, work, and exercise.

Pregnancy and breastfeeding

  • If you're pregnant or planning to be, tell your prenatal provider about this condition.
  • Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
  • Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
  • Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

  • Go to visits when you can and take notes.
  • Keep a list of medicines, allergies, and doctors in one place.
  • Learn the warning signs that need fast care.
  • Learn CPR. Many hospitals and the Red Cross offer classes.
  • Take breaks and ask for help. Caregivers need care too.

Outlook

Depends on cause; treatment saves lives.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

  • Oxygen settings

Questions to ask

  • Do I need oxygen at home?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Respiratory failure

Sources

Last updated 2026-11-12.