Respiratory High-Dependency Care Units for the burden of acute respiratory failure

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• 作者：Raffaele Scala ; ^{raffaele_scala@hotmail.com}
• 关键词：Respiratory High-Dependency Care Units ; Mechanical ventilation ; Noninvasive ventilation ; Acute respiratory failure ; Weaning ; Tracheostomy
• 刊名：European Journal of Internal Medicine
• 出版年：2012
• 期刊代码：91_09536205
• 类别：med
• 出版时间：June, 2012
• 卷：23
• 期：4
• 页码：302-308
• 文件大小：688 K

摘要

The burden of acute respiratory failure (ARF) has become one of the greatest epidemiological challenges for the modern health systems. Consistently, the imbalance between the increasing prevalence of acutely de-compensated respiratory diseases and the shortage of high-daily cost ICU beds has stimulated new health cost-effective solutions.

Respiratory High-Dependency Care Units (RHDCU) provide a specialised environment for patients who require an 鈥渋ntermediate鈥?level of care between the ICU and the ward, where non-invasive monitoring and assisted ventilation techniques are preferentially applied. Since they are dedicated to the management of 鈥渕ono-organ鈥?decompensations, treatment of ARF patients in RHDCU avoids the dangerous 鈥渦nder-assistance鈥?in the ward and unnecessary 鈥渙ver-assistance鈥?in ICU. RHDCUs provide a specialised quality of care for ARF with health resources optimisation and their spread throughout health systems has been driven by their high-level of expertise in non-invasive ventilation (NIV), weaning from invasive ventilation, tracheostomy care, and discharging planning for ventilator-dependent patients.