Respiratory failure causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  M. Khurram Afzal, MD [2]

## Overview

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Common causes of respiratory failure include pneumonia, pulmonary edema, pulmonary embolism, acute respiratory distress syndrome, atelectasis, asthma, COPD, neuromuscular and chest wall disorders, inadequate post-operative analgesia, smoking, obesity and shock. Life-threatening causes of respiratory failure include chronic obstructive pulmonary disease, acute on chronic respiratory failure, pulmonary infection, pulmonary embolism, heart failure, cardiac arrhythmia and lung cancer.

## Causes

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### Life-threatening causes

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* Life-threatening causes of respiratory failure include chronic obstructive pulmonary disease, acute on chronic respiratory failure, pulmonary infection, pulmonary embolism, heart failure, cardiac arrhythmia and lung cancer.[1]

### Causes of respiratory failure based on classification of disease

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Causes of respiratory failure based on classification of disease include:_National_Heart,_Lung,_and_Blood_Institute_(NHLBI)-2|[2]

* Type I respiratory failure:
* Pneumonia
* Cardiogenic pulmonary edema
* Caused by increased hydrostatic pressure in the pulmonary capillaries
* Non-cardiogenic pulmonary edema
* Caused by increased permeability in the pulmonary capillaries
* Acute lung injury
* Acute respiratory distress syndrome (ARDS)
* Pulmonary embolism
* Atelectasis
* Pulmonary fibrosis

* Type II respiratory failure:
* Central hypoventilation
* Asthma
* Chronic obstructive pulmonary disease (COPD)
* Hypoxemia and hypercapnia often coexist
* Neuromuscular and chest wall disorders
* Myopathies
* Neuropathies
* Kyphoscoliosis
* Myasthenia gravis [3]
* Obesity hypoventilation syndrome

* Type III respiratory failure:
* Inadequate post-operative analgesia
* Upper abdominal incision
* Obesity
* Ascites
* Pre-operative tobacco smoking
* Excessive airway secretions

* Type IV respiratory failure:
* Cardiogenic shock
* Septic shock
* Hypovolemic shock

### Drugs that can cause respiratory failure

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Common drugs that can cause respiratory failure include:[4][5]

* Azacitidine
* Codeine
* Clozapine
* Fentanyl
* Gamma-Hydroxybutyric acid
* Heroin
* Ketamine
* Lidocaine
* Labetalol
* Lorazepam
* Morphine
* Nitrazepam
* Opiate
* Oxymorphone
* Procainamide (patient information)
* Sodium thiopental
* Triazolam
* Zopiclone

### Causes by Organ System

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Cardiovascular |

Atrial septal defect (ostium primum), Ebstein anomaly, Eisenmenger syndrome, Fallot tetralogy, Pulmonary valve stenosis, Transposition of great arteries, Tricuspid valve stenosis, Ventricular septal defect, Heart failure, Cardiac arrhythmia, Shock

|

Chemical / poisoning | 3-Quinuclidinyl benzilate,

Abrin, Aldicarb, Alpha-amanitin, Barium nitrate, Bungarotoxin, Carbon monoxide poisoning, Ceritinib Cocaine, Cone snail, Furfural, Snakebites (Patient information)

Congenital |

Atrial septal defect (ostium primum), Bland-White-Garland Syndrome, Congenital Central Hypoventilation Syndrome, Congenital diaphragmatic hernia, Fallot tetralogy, Fetal circulation, persistent, Respiratory distress syndrome (neonatal)

Dermatologic | No underlying causes
Drug Side Effect  | Codeine, Clozapine, Crizotinib, Cyclophosphamide, Desmopressin, Dornase Alfa, Fentanyl, Gamma-Hydroxybutyric acid, galsulfase, Heroin, Idursulfase, interferon alfacon-1, Ixabepilone, Ketamine, Lidocaine, Labetalol, Lorazepam, Morphine, Nitrazepam, Opiate, Oxymorphone, Pegylated interferon alfa-2b, Pramipexole, Procainamide (patient information), Rasburicase, Sodium thiopental, Tretinoin, Triazolam, Vincristine sulfate liposome, Zopiclone
Ear Nose Throat | No underlying causes
Endocrine | No underlying causes
Environmental |

Asbestosis, Coal worker pneumoconiosis, Smoke inhalation, Sulfur dioxide

Gastroenterologic |

Hepatic failure, Hepatopulmonary syndrome

Genetic |

Achondrogenesis, Acute Porphyria, Alpha 1-antitrypsin deficiency, Atelosteogenesis, type II, Becker's muscular dystrophy, Carnitine palmitoyltransferase II deficiency, Cystic fibrosis, Duchenne's Muscular Dystrophy, Familial dysautonomia, Hereditary haemorrhagic telangiectasia, Osteogenesis imperfecta, Thanatophoric dysplasia

Hematologic |

Acute Porphyria, Cholesterol Emboli Syndrome, Fat embolism, Sepsis

Iatrogenic |

Blood transfusion, EVAR

Infectious Disease |

Babesiosis, Botulism, Crimean-Congo hemorrhagic fever, Hantavirus Pulmonary Syndrome, Heartworm, Post-polio syndrome, Rabies, Tetanus

Musculoskeletal / Ortho |

Kyphoscoliosis

Neurologic |

Amyotrophic Lateral Sclerosis, Meningitis, Polyrediculitis, Zellweger syndrome

Nutritional / Metabolic |

Metabolic Acidosis

Obstetric/Gynecologic | No underlying causes
Oncologic |

Malignant Mesothelioma

Ophthalmologic | No underlying causes
Overdose / Toxicity |

Acetylsalicylic acid, Alcohol, Bufotenin, Clitocybe dealbata, Colchicine, Cytisine, Dicofol, Saxitoxin, Tetrodotoxin, Tick paralysis, Vinyl chloride

Psychiatric | No underlying causes
Pulmonary |

Acute lung syndrome, Acute Respiratory Distress Syndrome, Alpha 1-antitrypsin deficiency, Atelectasis, Bronchial asthma, Bronchiectasis, Bronchiolitis, Bronchiolitis obliterans, Bronchogenic carcinoma, Bronchopulmonary dysplasia, Chronic Obstructive Pulmonary Disease, Cystic adenomatoid malformation of lung, Emphysema, Eosinophilic pneumonia, Fibrosing alveolitis, Flail chest, Interstitial fibrosis, Laryngo-/Bronchospasm, Legionella pneumophila, Pleural effusion, Pneumonia, Pneumothorax, Pulmonary alveolar proteinosis, Pulmonary arterio-venous malformation, Pulmonary edema, Pulmonary embolism, Pulmonary hypertension, Pulmonary oedema, Restrictive Lung Disease, Status asthmaticus, Lung cancer

Renal / Electrolyte |

Electrolyte abnormalities

Rheum / Immune / Allergy |

Acute motor axonal neuropathy, Anaphylaxis, Angioedema, Antiphospholipid Antibody Syndrome, Devic's disease, Guillain-Barre syndrome, Hamman-Rich Syndrome, Myasthenia Gravis, Satoyoshi syndrome

Trauma |

Ebstein anomaly, Flail chest

Urologic | No underlying causes
Miscellaneous |

Aspiration, Foreign body, Malignant hyperpyrexia, Multiple organ dysfunction syndrome, Near-drowning, Reye's syndrome

### Causes in Alphabetical Order

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* 3-Quinuclidinyl benzilate
* Acute lung syndrome
* Acute on chronic respiratory failure
* Abrin
* Acetylsalicylic acid
* Achondrogenesis
* Acute lung injury
* Acute motor axonal neuropathy
* Acute Porphyria
* Acute respiratory distress syndrome (ARDS)
* Alcohol
* Aldicarb
* Alpha 1-antitrypsin deficiency
* Alpha-amanitin
* Amyotrophic Lateral Sclerosis
* Anaphylaxis
* Angioedema
* Antiphospholipid Antibody Syndrome
* Asbestosis
* Ascites
* Aspiration
* Asthma
* Atelectasis
* Atelosteogenesis, type II
* Atrial septal defect (ostium primum)
* Azacitidine
* Babesiosis
* Barium nitrate
* Becker's muscular dystrophy
* Bland-White-Garland Syndrome
* Blood transfusion
* Botulism
* Bronchial asthma
* Bronchiectasis
* Bronchiolitis obliterans
* Bronchiolitis
* Bronchogenic carcinoma
* Bronchopulmonary dysplasia
* Bufotenin
* Bungarotoxin
* Central hypoventilation
* Coal worker pneumoconiosis
* Carbon monoxide poisoning
* Cardiac arrhythmia
* Cardiogenic pulmonary edema
* Cardiogenic shock
* Carnitine palmitoyltransferase II deficiency
* Ceritinib
* Cholesterol Emboli Syndrome
* Chronic obstructive pulmonary disease
* Clitocybe dealbata
* Clozapine
* Cocaine
* Codeine
* Colchicine
* Cone snail
* Congenital Central Hypoventilation Syndrome
* Congenital diaphragmatic hernia
* Crimean-Congo hemorrhagic fever
* Crizotinib
* Cyclophosphamide
* Cystic adenomatoid malformation of lung
* Cystic fibrosis
* Cytisine
* Desmopressin
* Devic's disease
* Dicofol
* Dornase Alfa
* Duchenne's Muscular Dystrophy
* Excessive airway secretions
* Ebstein anomaly
* Eisenmenger syndrome
* Emphysema
* Eosinophilic pneumonia
* EVAR
* Fallot tetralogy
* Familial dysautonomia
* Fat embolism
* Fentanyl
* Fetal circulation, persistent
* Fibrosing alveolitis
* Flail chest
* Foreign body
* Furfural
* galsulfase
* Gamma-Hydroxybutyric acid
* Guillain-Barre syndrome
* Hamman-Rich Syndrome
* Hantavirus Pulmonary Syndrome
* Heart failure
* Heartworm
* Hepatic failure
* Hepatopulmonary syndrome
* Hereditary haemorrhagic telangiectasia
* Heroin
* Hypovolemic shock
* Inadequate post-operative analgesia
* Idursulfase
* interferon alfacon-1
* Interstitial fibrosis
* Ixabepilone
* Ketamine
* Kyphoscoliosis
* Labetalol
* Laryngo-/Bronchospasm
* Legionella pneumophila
* Lidocaine
* Lorazepam
* Lung cancer
* Malignant hyperpyrexia
* Malignant Mesothelioma
* Meningitis
* Metabolic Acidosis
* Morphine
* Multiple organ dysfunction syndrome
* Myasthenia Gravis
* Myopathies
* Near-drowning
* Non-cardiogenic pulmonary edema
* Neuropathies
* Nitrazepam
* Obesity
* Opiate
* Osteogenesis imperfecta
* Oxymorphone
* Pegylated interferon alfa-2b
* Pleural effusion
* Pneumonia
* Pneumothorax
* Polyrediculitis
* Post-polio syndrome
* Pramipexole
* Procainamide
* Pulmonary alveolar proteinosis
* Pulmonary arterio-venous malformation
* Pulmonary edema
* Pulmonary embolism
* Pulmonary fibrosis
* Pulmonary hypertension
* Pulmonary edema
* Pulmonary valve stenosis
* Pulmonary infection
* Pre-operative tobacco smoking
* Rabies
* Rasburicase
* Respiratory distress syndrome (neonatal)
* Restrictive Lung Disease
* Reye's syndrome
* Sulfur dioxide
* Satoyoshi syndrome
* Saxitoxin
* Sepsis
* Septic shock
* Shock
* Smoke inhalation
* Snakebites
* Sodium thiopental
* Status asthmaticus
* Tetanus
* Tetrodotoxin
* Thanatophoric dysplasia
* Tick paralysis
* Transposition of great arteries
* Tretinoin
* Triazolam
* Tricuspid valve stenosis
* Upper abdominal incision
* Ventricular septal defect
* Vincristine *sulfate liposome
* Vinyl chloride
* Zellweger syndrome
* Zopiclone

## References

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1. ↑ Zielinski J, MacNee W, Wedzicha J, Ambrosino N, Braghiroli A, Dolensky J, Howard P, Gorzelak K, Lahdensuo A, Strom K, Tobiasz M, Weitzenblum E (February 1997). "Causes of death in patients with COPD and chronic respiratory failure". Monaldi Arch Chest Dis. 52 (1): 43–7. PMID 9151520.
2. _National_Heart,_Lung,_and_Blood_Institute_(NHLBI)_2-0|↑ "Respiratory Failure | National Heart, Lung, and Blood Institute (NHLBI)".
3. ↑ Roy TM, Walker JF, Farrow JR (April 1991). "Respiratory failure associated with myasthenia gravis". J Ky Med Assoc. 89 (4): 169–73. PMID 2040830.
4. ↑ Caruso AL, Bouillon TW, Schumacher PM, Luginbuhl M, Morari M (2007). "Drug-induced respiratory depression: an integrated model of drug effects on the hypercapnic and hypoxic drive". Conf Proc IEEE Eng Med Biol Soc. 2007: 4259–63. doi:10.1109/IEMBS.2007.4353277. PMID 18002943.
5. ↑ Wilson KC, Saukkonen JJ (2004). "Acute respiratory failure from abused substances". J Intensive Care Med. 19 (4): 183–93. doi:10.1177/0885066604263918. PMID 15296619.

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