Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients.

Journal Article

Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence.

Full Text

Duke Authors

Cited Authors

  • Morris, TA; Gay, PC; MacIntyre, NR; Hess, DR; Hanneman, SK; Lamberti, JP; Doherty, DE; Chang, L; Seckel, MA

Published Date

  • April 2017

Published In

Volume / Issue

  • 62 / 4

Start / End Page

  • 497 - 512

PubMed ID

  • 28341777

Electronic International Standard Serial Number (EISSN)

  • 1943-3654

International Standard Serial Number (ISSN)

  • 0020-1324

Digital Object Identifier (DOI)

  • 10.4187/respcare.05021

Language

  • eng