Respiratory Failure Treatment

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Acute respiratory failure can be life-threatening and may need a quick diagnosis and emergency medical treatment in a hospital. Emergency treatment can help quickly improve your breathing and provide oxygen to your body to help prevent organ damage. Your healthcare provider will then treat the cause of your respiratory failure. Treatments for respiratory failure may include oxygen therapy, medicines, and procedures to help your lungs rest and heal.

Chronic respiratory failure can often be treated at home. If you have serious chronic respiratory failure, you may need treatment in a long-term care center.

If you have respiratory failure, you may receive oxygen therapy. There are different ways to get oxygen into your lungs.

• A noninvasive positive pressure ventilation (NPPV) uses mild air pressure to keep your airways open. You may wear plastic tubes on your nose, or a mask, or another device that fits over your nose or your nose and mouth. A tube connects the mask to a machine that blows air into the tube. Continuous positive airway pressure (CPAP) is one type of NPPV.
• Bag mask ventilation uses a bag, which is attached to a mask that you wear, to pump more air into your lungs. This is often done while you are waiting for a complex procedure to treat the cause of your respiratory failure.
• A mechanical ventilator is a machine that supports breathing. It blows air — or air with increased amounts of oxygen — into your airways and then your lungs. Your healthcare provider may treat you with a ventilator if the oxygen level in your blood doesn’t increase with NPPV, or if you're still having trouble breathing. Using a ventilator, especially for a long time, can damage your lungs and airways and cause infections such as pneumonia.
• A tracheostomy is a surgically made hole that goes through the front of your neck and into your windpipe. A breathing tube is placed in the hole to deliver oxygen when your airways are blocked.

• Extracorporeal membrane oxygenation (ECMO) pumps your blood through an artificial lung to add oxygen and remove carbon dioxide before returning the blood to your body. Healthcare providers use ECMO to treat people with severe breathing problems. It may be used for several days or weeks to give the lungs a chance to recover. Some complications of ECMO are blood clots, bleeding, and infections, all of which can be life-threatening.

Your doctor may prescribe medicines to improve your symptoms or treat the cause of your respiratory failure.

• Antibiotics can treat bacterial lung infections such as pneumonia.
• Bronchodilators work by opening your airways.
• Corticosteroids control inflammation in the airways.

If you have to stay in the hospital for a while, you may need treatments to avoid or manage other conditions or complications.

• Blood-thinning medicine: If you are very sick or got sick very quickly, this medicine can prevent blood clots from forming. If you cannot use a blood thinner for some reason, your doctor may order special stockings or devices to increase the pressure on your legs.
• Fluids: Fluids improve blood flow throughout your body and keep you hydrated. Fluids are usually given through an intravenous (IV) line inserted in one of your blood vessels.
• Nutritional support: You may need a feeding tube to make sure you get enough of the right nutrients while you are on a ventilator.
• Physical therapy: This can help maintain muscle strength and prevent sores from forming. Movement may also help shorten the time you are on a ventilator and improve recovery after you leave the hospital.
• Positioning your body: For severe respiratory failure, your doctor may recommend that you spend most of the time lying face down, which helps oxygen get to more of your lungs.
• Pulmonary rehabilitation: This program of education and exercise teaches you breathing techniques that can improve your oxygen levels.