Respiratory Failure In Adults: An Updated Review Article for Healthcare Professionals

Abstract

Background: Respiratory failure is a critical condition characterized by the inability of the respiratory system to maintain adequate oxygenation (Type 1) or carbon dioxide elimination (Type 2). It can be acute, chronic, or acute-on-chronic, with varying etiologies including pulmonary, cardiac, neuromuscular, and systemic disorders. Prompt recognition and intervention are essential to prevent life-threatening complications.

Aim: This review provides an updated clinical approach to diagnosing and managing respiratory failure in adults, emphasizing early identification, pathophysiology, and evidence-based treatment strategies.

Methods: A comprehensive evaluation of respiratory failure involves history, physical examination, arterial blood gas (ABG) analysis, imaging (chest X-ray, CT), capnometry, and point-of-care ultrasound. Laboratory tests, electrocardiography, and specialized diagnostics (e.g., bronchoscopy, polysomnography) are used as needed.

Results: Type 1 respiratory failure (hypoxemic) arises from impaired oxygen diffusion, ventilation-perfusion (V/Q) mismatch, or shunting, while Type 2 (hypercapnic) results from alveolar hypoventilation due to central, neuromuscular, or mechanical causes. Treatment includes oxygen therapy, noninvasive ventilation (NIV), or invasive mechanical ventilation, depending on severity. Mortality varies by etiology, with higher rates in ARDS (44.3%) and pneumonia (48.4%) requiring intubation.

Conclusion: Early diagnosis and tailored interventions improve outcomes. Multidisciplinary care involving pulmonologists, intensivists, nurses, and respiratory therapists is crucial. Patient education on medication adherence, vaccination, and smoking cessation reduces exacerbation risks.