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

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.

Causes

Life-threatening Causes

• 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 of respiratory failure include:

• 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
  • 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

Common drugs that can cause respiratory failure include:

• 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

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

chronic obstructive pulmonary disease acute on chronic respiratory failure pulmonary infection pulmonary embolism heart failure cardiac arrhythmia lung cancer Pneumonia Cardiogenic pulmonary edema Non-cardiogenic pulmonary edema Acute lung injury Acute respiratory distress syndrome (ARDS) Pulmonary embolism Atelectasis Pulmonary fibrosis Central hypoventilation Asthma Chronic obstructive pulmonary disease Myopathies Neuropathies Kyphoscoliosis Myasthenia gravis Inadequate post-operative analgesia Upper abdominal incision Obesity Ascites Pre-operative tobacco smoking Excessive airway secretions Cardiogenic shock Septic shock Hypovolemic shock Azacitidine Codeine Clozapine Fentanyl Gamma-Hydroxybutyric acid Heroin Ketamine Lidocaine Labetalol Lorazepam Morphine Nitrazepam Opiate Oxymorphone Procainamide (patient information) Sodium thiopental Triazolam Zopiclone 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 3-Quinuclidinyl benzilate Abrin Aldicarb Alpha-amanitin Barium nitrate Bungarotoxin Carbon monoxide poisoning Ceritinib Cocaine Cone snail Furfural Snakebites 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) 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 Asbestosis, Coal worker pneumoconiosis, Smoke inhalation, Sulfur dioxide Hepatic failure, Hepatopulmonary syndrome 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 Acute Porphyria, Cholesterol Emboli Syndrome, Fat embolism, Sepsis Blood transfusion, EVAR Babesiosis, Botulism, Crimean-Congo hemorrhagic fever, Hantavirus Pulmonary Syndrome, Heartworm, Post-polio syndrome, Rabies, Tetanus Kyphoscoliosis Amyotrophic Lateral Sclerosis, Meningitis, Polyrediculitis, Zellweger syndrome Metabolic Acidosis Malignant Mesothelioma Acetylsalicylic acid, Alcohol, Bufotenin, Clitocybe dealbata, Colchicine, Cytisine, Dicofol, Saxitoxin, Tetrodotoxin, Tick paralysis, Vinyl chloride 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 Acute motor axonal neuropathy Anaphylaxis Angioedema Antiphospholipid Antibody Syndrome Devic's disease Guillain-Barre syndrome Hamman-Rich Syndrome Myasthenia Gravis Satoyoshi syndrome Ebstein anomaly Flail chest Aspiration Foreign body Malignant hyperpyrexia Multiple organ dysfunction syndrome Near-drowning Reye's syndrome