Acute respiratory failure: back to the roots!

Excerpt

Hypoxic respiratory failure is one of the most commonest disorders leading to intensive care unit (ICU) admission and also a common reason for the deterioration of patients already treated in the ICU. It is a very serious condition associated with significant mortality [1, 2]. In recent decades, research and scientific attention has focused nearly exclusively on the pathophysiology and treatment of established causes of hypoxic respiratory failure such as cardiogenic pulmonary edema and the acute respiratory distress syndrome (ARDS) [1, 2]. Therefore, our diagnostic approach to patients with hypoxic respiratory failure has remained both largely unchanged and poorly validated. This is a dilemma because diagnostic uncertainty is very common. The severity of disease and the requirement for immediate ventilatory support often limit our ability to obtain a detailed patient history and physical examination. Chest X-ray is helpful but also associated with important limitations [3]. …