The Management of Acute Respiratory Failure in a Respiratory Intensive Care Unit

¹ Department of Internal Medicine, Medical College of Virginia, Health Sciences Division of the Virginia Commonwealth University, Richmond, Virgina

The over-all management of acute respiratory failure has been greatly facilitated by the modern respiratory intensive care unit with improved techniques in patient care. The mortality from acute respiratory failure at the Medical College of Virginia Hospital has been reduced by about fivefold for patients treated in such a unit. During the first two years of operation of the respiratory intensive care unit (RICU) there were 269 admissions for acute respiratory failure. Ninetyeight of these admissions were for acute respiratory failure in association with chronic obstructive pulmonary disease (COPD). Many of these patients had failed to improve with controlled, low-flow oxygen therapy prior to admission to the RICU and therefore presented a more difficult problem of management with greater expected mortality. Seventy-six percent of the COPD patients were managed with a tracheostomy. The mortality in the 98 episodes of acute respiratory failure from COPD was 7.1 percent.