Chronic respiratory failure

FEVj < 30% or presence of chronic respiratory failure or right heart failure... 

Add long-term oxygen therapy if chronic respiratory failure ° Consider surgical treatments... 

IV Very severe Long-term oxygen if chronic respiratory failure... 

Long-term administration of oxygen (greater than 15 hours per day) to patients with chronic respiratory failure has been shown to reduce mortality and improve quality of life.1,2 Oxygen therapy should be initiated in stable patients with very severe COPD (GOLD stage IV) who are optimized on... 

De Souich P, Erill S. Metabolism of procainamide in patients with chronic heart failure, chronic respiratory failure and chronic renal failure. Eur J Clin Pharm 1976 10 283-287. 

Weitzenblum E, Parini JP, Roeslin N. The effects on ventilation, gas exchange and haemodynamics of the respiratory stimulation of doxapram in cases of chronic respiratory failure. J Med Strasb 1973 4 1063. 

Acute respiratory failure N Chronic respiratory failure N Bone and joint disease... 

Ventilatory Support for Chronic Respiratory Failure, edited by Nicolino Ambrosino and Roger S. Goldstein... 

Respiratory failure can develop over minutes to hours (acute respiratory failure) or over several days or longer (chronic respiratory failure). The distinction between acute and... 

III. Pathophysiology of Chronic Respiratory Failure A. Hypoxemic Respiratory Failure... 

In patients with kyphoscoliosis the severity is quantified by measuring the angle between the upper and lower portions of the spinal curve (Cobb angle). When this angle exceeds 100° (severe scoliosis), the vital capacity falls below 50% of the predicted value (48). A major factor in the pathophysiology of chronic respiratory failure in patients with kyphoscoliosis is the decrease in the compliance of the chest wall and limgs (49,50). In severe scoliosis the compliance of the chest wall may be about 25% of the predicted value. 

Abbreviations-. CRF, chronic respiratory failure HMV, home mechanical ventilation. 

Neri M, Melani AS, Miorelli AM, et al. Long-term oxygen therapy in chronic respiratory failure a multicenter Italian study on oxygen therapy adherence (MISOTA). Respir Med 2006 ... 

Goldberg A, Leger P, Hill NS, et al. Clinical indications for noninvasive positive pressure ventilation in chronic respiratory failure due to restrictive lung disease, COPD, and nocturnal hypoventilation-a consensus conference report. Chevy Chase, MD National Association for Medical Direction of Respiratory Care, 1999 521-534. 

Fauroux B, Sardet A, Foret D. Home treatment for chronic respiratory failure in children a prospective study. Eur Respir J 1995 8 2062-2066. 

Each year, over 400,000 patients in the United States receive mechanical ventilation as a result of acute or acute-on-chronic respiratory failure (1,2). About a quarter of acutely ventilated patients repeatedly fail attempts at weaning and may require prolonged mechanical ventilation (PMV) (Fig. 1) (3,4). The proportion of patients experiencing PMV ranges between 0% and 20% (5-13). Out of patients who survive PMV, 9-66% become dependent on long-term mechanical ventilation (LTMV) (4,9,14-21). Two factors account for these wide variations in the outcome. The first factor is differences in patient population. The second one is the nosology of what constitutes PMV and what constitutes LTMV is unsatisfactory. 

Rossi A, Poggi R, Roca J. Physiologic factors predisposing to chronic respiratory failure. Respir Care Clin N Am 2002 8(3) 379-404. 

A three-month prospective cohort study of 26 Italian RICUs reported on 756 patients (14). Of all patients receiving invasive mechanical ventilation, 61% were tracheotomized and therefore considered ventilator dependent. According to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the predicted mortality was 22%, while the actual mortality rate was 16%. The results indicate that units with a level of care below ICU can successfiilly manage patients with acute-on-chronic respiratory failure. 

Ambrosino N, Bmletti G, Scala V, et al. Cognitive and perceived health status in patient with chronic obstructive pulmonary disease surviving acute on chronic respiratory failure a controlled study. Intensive Care Med 2002 28 170-177. 

Euteneuer S, Windisch W, Suchi S, et al. Health-related quality of life in patients with chronic respiratory failure after long-term mechanical ventilation. Respir Med 2006 100 477-486. 

Jakobsson P, Jordfelt I, Brundin A. Skeletal musele metabolites and fiber types in patients with advanced COPD with and without chronic respiratory failure. Eur Respir J 1990 3 192—196. 

Carone M, Bertolotti G, Anchisi F, et al. Analysis of factors that characterize health impairment in patients with chronic respiratory failure. Eur Respir J 1999 13 1293-1300. 

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