Impact of Respiratory Compromise

Respiratory compromise is a state in which there is a high likelihood of decompensation into respiratory insufficiency and failure, respiratory arrest or death, but in which specific interventions (continuous monitoring and therapies) might prevent or mitigate decompensation.¹ 

Many in-hospital declines may be preventable with better respiratory monitoring and early intervention.^2,3,4

Respiratory abnormalities are the most common type of abnormalities prior to ICU admission. ⁵ Moreover, inpatients with respiratory insufficiency, arrest and failure originating on the general care floor have higher mortality rates, longer length of stay and ICU stays compared to other patients.⁶

Therefore, implementing better strategies for prevention, monitoring for and management of respiratory abnormalities in patients could lead to improved patient outcomes and decreased costs.

Respiratory insufficiency is one of the most common and serious complications during postoperative period.⁷ Postoperative respiratory insufficiency risk is increased in emergency surgical procedures (particularly procedures related to trauma), procedures involving the chest or upper abdomen, as well as procedures requiring prolonged anesthesia.⁷ Additional important risk factors include prolonged sedation, neuromuscular blockade, cardiovascular instability, immobilization and respiratory problems.⁸ Typically, respiratory insufficiency treatment strategies are directed at addressing the cause of the insufficiency and restoration of pulmonary function.⁷ Therefore, it is important to have consistent strategies for respiratory insufficiencyprevention, including monitoring and preoperative conditioning in high-risk patients.⁸ 

Postoperative respiratory failure is the most frequent postoperative pulmonary complication with major impact on patient outcome and health costs.⁹ The pathogenesis of postoperative failure isdependent upon factors related to patient status, as well as anaesthetic and surgical procedure employed.10 The incidence of postoperative respiratory failure in the general surgical populations varies between 0.2% and 3.4% (Canet and Gallart, 2014). ¹⁰

Discover below what impact respiratory compromise has and which respiratory and monitoring solutions from Medtronic can help with the early identification.

Respiratory compromise imposes substantial burdens on patient health and hospital costs.

Recent research has demonstrated a reduction in respiratory compromise (from respiratory insufficiency to failure) during procedural sedation with the use of capnography monitoring.¹¹ Specifically, use of capnography was associated with less mild and severe oxygen desaturation, which may have contributed to reduced need for assisted ventilation.¹¹

Acute respiratory failure implies the inability of the respiratory system to meet the oxygenation, ventilation, or metabolic requirements of the patient (Gurka and Balk, 2008).¹² Hypoxic respiratory failure (type 1) is defined as hypoxia without hypercapnia and with an arterial partial pressure of oxygen (PaO2) of <60 mmHg (<8 kPa) on room air at sea level.¹³ Hypercapnic respiratory failure (type 2) is defined as hypoxia with an arterial partial pressure of carbon dioxide (PaCO2) of >50 mmHg (>6.5 kPa) on room air at sea level.¹³  

Chronic respiratory failure typically refers to a combination of chronic hypoxemia, hypercapnea and compensatory metabolic alkalosis, resulting in chronically low oxygen levels or chronically high carbon dioxide levels.^14,15 The condition is usually caused by chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), chronic bronchitis, and idiopathic interstitial pneumonia.