Respiratory failure is a life-threatening situation in which the respiratory system stops functioning properly. Respiratory failure occurs when the lungs and respiratory system become unable to provide the body with sufficient oxygen and fail to “blow off ” accumulated carbon dioxide. If the major cause of respiratory failure is an inability of the lungs to get in enough oxy-gen to meet the body’s oxygen requirement, then it is referred to as hypoxemic respiratory failure. Respiratory failure in CHF can be very gradual and may progress slowly over hours or days. Acute respiratory failure is characterized by the onset of shortness of breath that occurs over hours or days.
This can occur in CHF patients when they exercise too much, don’t take their medicines, or have too much salt in their diets. It can also occur when the patient acquires a lung infection or is exposed to lung irritants that cause inflammation and increased mucous production. CHF can lead to severe respiratory failure. In respiratory failure, there can come a point where the failure becomes so marked that the body becomes deprived of oxygen or the level of carbon dioxide too high. When these conditions occur, other organs can begin to fail as well from the lack of oxygen. The brain is particularly sensitive to lack of oxygen and the build-up of carbon dioxide.
In this state, the patient can become confused, unable to make appropriate decisions about his or her treatment, may lose consciousness, go into a coma, and if this state is prolonged and the oxygen levels become too low, the patient can die. Clearly, severe respiratory failure is a medical emergency; the patient is critically ill and requires the attention of a physician and needs to be admitted to the hospital. Because of the effect of respiratory failure on the brain, it is inappropriate to allow the patient in severe failure to make decisions about visiting the doctor or emergency room. This is a situation in which a relative or friend must make decisions for the patient and get the proper emergency care.