Diseases of respiratory insufficiency

When breathing is impaired, your lungs can’t easily move oxygen into your blood and remove carbon dioxide from your blood (gas exchange). This can cause a low oxygen level or high carbon dioxide level, or both, in your blood.

Respiratory insufficiency refers to conditions that reduce your body’s ability to perform gas exchange, including:

  • Chronic Obstructive Pulmonary Disease (COPD): a progressive lung disease that includes emphysema and chronic bronchitis. Asthma and rare genetic conditions, such as cystic fibrosis, can also lead to COPD.
  • Interstitial Lung Disease: represents a large group of conditions that scar the alveoli (the air sacs in your lungs) and decrease your lungs’ ability to perform gas exchange
  • Neuromuscular Disease: refers to conditions that affect the nerves and muscles that control breathing. Examples include amyotrophic lateral sclerosis (ALS), often called Lou Gehrig’s disease; muscular dystrophies; and myasthenia gravis. As these conditions progress, loss of nerve function can lead to difficulty in breathing and respiratory insufficiency
  • Restrictive Lung Disease: refers to conditions where lung volumes are limited, reducing the lungs’ ability to fully fill with air

COPD is a major cause of disability and the third leading cause of death in the United States.1

Symptoms of COPD

Common signs and symptoms of COPD include:

  • An ongoing cough or a cough that produces a lot of mucus
  • Shortness of breath, especially with minimal physical activity
  • Wheezing (a whistling or squeaky sound when you breathe)
  • Chest tightness

COPD develops slowly. As the disease becomes worse, symptoms usually become more severe and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.

COPD Population Screener may help you determine if you are at risk for developing COPD

Diagnosis and treatments

One simple, noninvasive test that your doctor may recommend is called a spirometry. It measures how much air you exhale and how fast you exhale it. It can also tell how well your lungs deliver oxygen to your blood.

Your doctor may recommend other tests, such as:

  • Chest X-ray or chest CT scan: shows the structures inside your chest and can detect lung damage or symptoms of respiratory insufficiency
  • Arterial blood gas (ABG) test: measures your oxygen level by taking a blood sample from your artery. The results from this test can show how severe your disease is and if you need oxygen therapy

The goals of treatment for respiratory insufficiency include:

  • Relieving your symptoms
  • Slowing the progress of the disease
  • Improving your exercise tolerance (your ability to stay active)
  • Preventing and treating complications
  • Improving your overall health

Various treatments are used to treat respiratory insufficiency, including:

Treatment Description
Pulmonary rehabilitation pulmonary Pulmonary rehabilitation is a program of exercise, education, and support to help you learn to breathe—and function—at the highest level possible. Rehabilitation activities can make a substantial difference in slowing the progression of lung conditions and helping you stay active.
Oxygen therapy pulmonary When the oxygen level in your blood becomes low, oxygen therapy may be prescribed. Usually a nasal cannula connected to an oxygen source is worn beneath the nose. At home, this oxygen source may be an oxygen cylinder or an oxygen concentrator. In hospitals, there are oxygen sources readily available.
Ventilation pulmonary A mechanical ventilator is a device that makes it easier for you to breathe by providing your lungs with pressurized volumes of air. This treatment may be used if you have trouble breathing on your own or your lungs are having difficulty performing enough gas exchange for your body’s needs.
Medications pulmonary Medications may relax the muscles around your airways, helping them open wider. These medications may include bronchodilators and inhaled glucocorticosteroids (steroids).
Surgery pulmonary Surgery usually is a last resort for people who have severe symptoms that have not improved with other treatments. Types of surgeries include bullectomy and lung volume reduction surgery. For example, a lung transplant might be an option for people who have very severe COPD.
Pulmonary rehabilitation
Pulmonary rehabilitation is a program of exercise, education, and support to help you learn to breathe—and function—at the highest level possible. Rehabilitation activities can make a substantial difference in slowing the progression of lung conditions and helping you stay active.
Oxygen therapy
When the oxygen level in your blood becomes low, oxygen therapy may be prescribed. Usually a nasal cannula connected to an oxygen source is worn beneath the nose. At home, this oxygen source may be an oxygen cylinder or an oxygen concentrator. In hospitals, there are oxygen sources readily available.
Ventilation
A mechanical ventilator is a device that makes it easier for you to breathe by providing your lungs with pressurized volumes of air. This treatment may be used if you have trouble breathing on your own or your lungs are having difficulty performing enough gas exchange for your body’s needs.
Medications
Medications may relax the muscles around your airways, helping them open wider. These medications may include bronchodilators and inhaled glucocorticosteroids (steroids).
Surgery
Surgery usually is a last resort for people who have severe symptoms that have not improved with other treatments. Types of surgeries include bullectomy and lung volume reduction surgery. For example, a lung transplant might be an option for people who have very severe COPD.

For a list of organizations that provide information and support for patients with respiratory diseases, visit our Resources page

Reference
1. National Institutes of Health. What is COPD? National Heart, Lung, and Blood Institute website. http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Accessed February 1, 2016.

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