Respiratory Care in the Absence of a Respiratory Care Unit

¹ Professor of Anesthesiology, at the University of Miami School of Medicine, Miami, Fla.
² Department of Anesthesiology and Division of Respiratory Care, University of Maryland School of Medicine, Baltimore, Md.

The purpose of this investigation was to study the effects, results and complications of a respiratory care team in seven different intensive care units in a large general hospital. These ICU's were of diverse origin, all separated geographically and administratively. One hundred and ninety-two patients in respiratory failure were ventilated for more than 12 hours. Of 77 patients in primary failure, 62 survived; of 115 patients with secondary failure with various medical-surgical problems, only 53 survived. There were seven deaths from therapeutic misadventures. The best survival record was in victims of chronic obstructive pulmonary disease, with the worst in neonatal idiopathic respiratory distress syndrome and after-cardiac arrest. The type of ventilator used, the subject of tracheal intubation versus tracheostomy and the ICU itself had little significant influence on survival. The respiratory care team contributed towards improvement in morbidity and mortality. The most important contribution is believed to be the dispensing of previously poorly or unperformed services and specific facts and information to both physicians and nurses.