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]


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.


Life-threatening causes

Causes of respiratory failure based on classification of disease

Causes of respiratory failure based on classification of disease include:[2]

Drugs that can cause respiratory failure

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

Causes by Organ System


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)


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

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

Infectious Disease

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

Musculoskeletal / Ortho



Amyotrophic Lateral Sclerosis, Meningitis, Polyrediculitis, Zellweger syndrome

Nutritional / Metabolic

Metabolic Acidosis

Obstetric/Gynecologic No underlying causes

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

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


Ebstein anomaly, Flail chest

Urologic No underlying causes

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

Causes in Alphabetical Order


  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. "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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