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

European Journal of Internal Medicine
Raffaele Scala

Abstract

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 "intermediate" 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 "mono-organ" decompensations, treatment of ARF patients in RHDCU avoids the dangerous "under-assistance" in the ward and unnecessary "over-assistance" 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.

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Citations

Mar 3, 2015·Revue de pneumologie clinique·N FreymondF Wallet
Jan 29, 2014·Archivos de bronconeumología·Javier Navarro Esteva, Antonio M Esquinas Rodríguez
Jul 22, 2014·The Clinical Respiratory Journal·Antonello NicoliniLorenzo Ferrera
Feb 23, 2017·Internal Medicine Journal·Craig HukinsJohn Upham
Jul 13, 2018·The European Respiratory Journal·Raffaele ScalaAntonio Artigas
Nov 8, 2018·ERJ Open Research·Szymon SkoczyńskiPaolo Navalesi
Aug 10, 2019·Geriatrics & Gerontology International·Paolo RuggeriAntonio Esquinas
Jul 1, 2020·Critical Care : the Official Journal of the Critical Care Forum·Raffaele ScalaAdriano Vaghi

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