Screen Siren Jane Russell succumbs

Jane Russell, one of Hollywood’s leading sex symbols in the 1940s and 1950s, has died. She was 89. Discovered by eccentric billionaire Howard Hughes, Russell made her movie debut in the film, The Outlaw. The movie originally had difficulty with movie censors because of the way her ample cleavage was shown and was only shown in limited release. Later she starred in a number of films with Bob Hope, and co-starred with Marilyn Monroe in Gentlemen Prefer Blonds. She died in Santa Maria, CA of respiratory failure.

What Is Respiratory Failure?

Respiratory failure is a condition in which not enough oxygen passes from the  lungs into the blood. The body’s organs, such as the heart and brain, need oxygen-rich blood to work well. Respiratory failure also can occur if the lungs can’t properly remove carbon dioxide (a waste gas) from the blood. Too much carbon dioxide in the blood can cause harm to organs. Both of these problems—a low oxygen level and a high carbon dioxide level in the blood—can occur at the same time.

Diseases and conditions that affect the breathing can cause respiratory failure. Examples include COPD (chronic obstructive pulmonary disease) and spinal cord injuries. COPD prevents enough air from flowing in and out of the airways. Spinal cord injuries can damage the nerves that control breathing.

To understand respiratory failure, it helps to understand how the lungs work. When you breathe, air passes through your nose and mouth into your windpipe. The air then travels to your lungs’ air sacs. These sacs are called alveoli .

Small blood vessels called capillaries run through the walls of the air sacs. When air reaches the air sacs, the oxygen in the air passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide moves from the capillaries into the air sacs. This process is called gas exchange.

In respiratory failure, gas exchange is impaired.

Respiratory failure can be acute (short term) or chronic (ongoing). Acute respiratory failure can develop quickly and may require emergency treatment. Chronic respiratory failure develops more slowly and lasts longer.

Signs and symptoms of respiratory failure may include shortness of breath, rapid breathing, and air hunger (feeling like you can’t breathe in enough air). In severe cases, signs and symptoms may include a bluish color on your skin, lips, and fingernails; confusion; and sleepiness.

One of the main goals of treating respiratory failure is to get oxygen to your lungs and other organs and remove carbon dioxide from your body. Another goal is to treat the underlying cause of the condition.

Acute respiratory failure usually is treated in an intensive care unit. Chronic respiratory failure can be treated at home or at a long-term care center.

The outlook for respiratory failure depends on how severe its underlying cause is, how quickly treatment begins, and your overall health.

People who have severe lung diseases may need long-term or ongoing breathing support, such as oxygen therapy or the help of a ventilator. A ventilator is a machine that helps you breathe. It blows air—or air with increased amounts of oxygen—into your airways and then your lungs.

What Causes Respiratory Failure?

Certain diseases and conditions that impair breathing can cause respiratory failure. These diseases and conditions may affect the muscles, nerves, bones, or tissues that support breathing, or they may affect the lungs directly.

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 failure can occur as a result of:

  • Conditions that affect the nerves and muscles that control breathing. Examples of these conditions include muscular dystrophy, amyotrophic lateral sclerosis (ALS), spinal cord injuries, and stroke.
  • Damage to the tissues and ribs around the lungs. This damage can occur from an injury to the chest.
  • Problems with the spine, such as scoliosis (a curve in the spine). This condition can affect the bones and muscles used for breathing.
  • Drug and/or alcohol overdose. An overdose affects the area of the brain that controls breathing. During an overdose, breathing becomes slow and shallow.
  • Lung diseases and conditions, such as COPD (chronic obstructive pulmonary disease), pneumonia, ARDS (acute respiratory distress syndrome), pulmonary embolism, and cystic fibrosis. These diseases and conditions can affect the flow of air and blood into and out of your lungs. ARDS and pneumonia affect gas exchange in the air sacs.
  • Acute lung injuries. For example, inhaling harmful fumes or smoke can injure your lungs.

For more information about respiratory failure, click here to go to the Resounding Health Casebook on the topic.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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