Epidemiology of Acute Respiratory Failure and Mechanical Ventilation

  • H. S. Suri
  • G. Li
  • O. Gajic
Conference paper


Acute respiratory failure, and the need for mechanical ventilation, remains one of the most common reasons for admission to the intensive care unit (ICU). The burden of acute respiratory failure is high in terms of mortality and morbidity as well as the cost of its principal treatment, mechanical ventilation. Very few epidemiologic studies have evaluated the prevalence and outcome of acute respiratory failure and mechanical ventilation in general. Most of the published literature has focused on specific forms of acute respiratory failure, particularly acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In this chapter, we provide a brief review of the pathophysiology of acute respiratory failure, its definition and classification, and then present the incidence and outcomes of specific forms of acute respiratory failure from epidemiologic studies.


Chronic Obstructive Pulmonary Disease Mechanical Ventilation Continuous Positive Airway Pressure Acute Lung Injury Idiopathic Pulmonary Fibrosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lewandowski K, Metz J, Deutschmann C, et al (1995) Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany. Am J Respir Crit Care Med 151:1121–1125.PubMedGoogle Scholar
  2. 2.
    Luhr OR, Antonsen K, Karlsson M, et al (1999) Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med 159:1849–1861PubMedGoogle Scholar
  3. 3.
    Behrendt CE (2000) Acute respiratory failure in the United States: incidence and 31-day survival. Chest 118:1100–1105PubMedCrossRefGoogle Scholar
  4. 4.
    Esteban A, Anzueto A, Frutos F, et al (2002) Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 287:345–355PubMedCrossRefGoogle Scholar
  5. 5.
    Vincent JL, Sakr Y, Ranieri VM (2003) Epidemiology and outcome of acute respiratory failure in intensive care unit patients. Crit Care Med 31(suppl 4):S296–299PubMedCrossRefGoogle Scholar
  6. 6.
    Flaatten H, Gjerde S, Guttormsen AB, et al (2003) Outcome after acute respiratory failure is more dependent on dysfunction in other vital organs than on the severity of the respiratory failure. Crit Care 7:R72PubMedCrossRefGoogle Scholar
  7. 7.
    Vincent JL, Akca S, De Mendonca A, et al (2002) The epidemiology of acute respiratory failure in critically ill patients. Chest 121:1602–1609PubMedCrossRefGoogle Scholar
  8. 8.
    Doyle RL, Szaflarski N, Modin GW, Wiener-Kronish JP, Matthay MA (1995) Identification of patients with acute lung injury. Predictors of mortality. Am J Respir Crit Care Med 152:1818–1824PubMedGoogle Scholar
  9. 9.
    Suchyta MR, Orme JF, Jr., Morris AH (2003) The changing face of organ failure in ARDS. Chest 124:1871–1879PubMedCrossRefGoogle Scholar
  10. 10.
    Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967) Acute respiratory distress in adults. Lancet 2:319–323PubMedCrossRefGoogle Scholar
  11. 11.
    Bernard GR, Artigas A, Brigham KL, et al (1994) The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149:818–824PubMedGoogle Scholar
  12. 12.
    Hughes M, MacKirdy FN, Ross J, Norrie J, Grant IS (2003) Acute respiratory distress syndrome: an audit of incidence and outcome in Scottish intensive care units. Anaesthesia 58:838–845PubMedCrossRefGoogle Scholar
  13. 13.
    Bersten AD, Edibam C, Hunt T, Moran J (2002) Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States. Am J Respir Crit Care Med 165:443–448PubMedGoogle Scholar
  14. 14.
    Goss CH, Brower RG, Hudson LD, Rubenfeld GD (2003) Incidence of acute lung injury in the United States. Crit Care Med 31:1607–1611PubMedCrossRefGoogle Scholar
  15. 15.
    Rubenfeld GD, Caldwell E, Peabody E, et al (2005) Incidence and outcomes of acute lung injury. N Engl J Med 353:1685–1693PubMedCrossRefGoogle Scholar
  16. 16.
    The Acute Respiratory Distress Syndrome Network. (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRefGoogle Scholar
  17. 17.
    Zilberberg MD, Epstein SK (1998) Acute lung injury in the medical ICU: comorbid conditions, age, etiology, and hospital outcome. Am J Respir Crit Care Med 157:1159–1164PubMedGoogle Scholar
  18. 18.
    Stauffer JL, Fayter NA, Graves B, Cromb M, Lynch JC, Goebel P (1993) Survival following mechanical ventilation for acute respiratory failure in adult men. Chest 104:1222–1229PubMedCrossRefGoogle Scholar
  19. 19.
    Kraus PA, Lipman J, Lee CC, et al (1993) Acute lung injury at Baragwanath ICU. An eightmonth audit and call for consensus for other organ failure in the adult respiratory distress syndrome. Chest 103:1832–1836PubMedCrossRefGoogle Scholar
  20. 20.
    Squara P, Dhainaut JF, Artigas A, Carlet J (1998) Hemodynamic profile in severe ARDS: results of the European Collaborative ARDS Study. Intensive Care Med 24:1018–1028PubMedCrossRefGoogle Scholar
  21. 21.
    Monchi M, Bellenfant F, Cariou A, et al (1998) Early predictive factors of survival in the acute respiratory distress syndrome. A multivariate analysis. Am J Respir Crit Care Med 158: 1076–1081PubMedGoogle Scholar
  22. 22.
    Peters SG, Meadows JA, 3rd, Gracey DR (1988) Outcome of respiratory failure in hematologic malignancy. Chest 94:99–102PubMedCrossRefGoogle Scholar
  23. 23.
    Yilmaz M, Iscimen R, Keegan MT, et al (2007) Six-month survival of patients with acute lung injury: Prospective cohort study. Crit Care Med 35:2303–2307PubMedCrossRefGoogle Scholar
  24. 24.
    Montgomery AB, Stager MA, Carrico CJ, Hudson LD (1985) Causes of mortality in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 132:485–489PubMedGoogle Scholar
  25. 25.
    Ferring M, Vincent JL (1997) Is outcome from ARDS related to the severity of respiratory failure? Eur Respir J 10(6):1297–1300PubMedCrossRefGoogle Scholar
  26. 26.
    Hopkins RO, Weaver LK, Pope D, Orme JF, Bigler ED, Larson LV (1999) Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Am J Respir Crit Care Med 160:50–56PubMedGoogle Scholar
  27. 27.
    Herridge MS, Cheung AM, Tansey CM, et al (2003) One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683–693PubMedCrossRefGoogle Scholar
  28. 28.
    Schelling G, Stoll C, Haller M, et al (1998) Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 26: 651–659PubMedCrossRefGoogle Scholar
  29. 29.
    Esteban A, Anzueto A, Alia I, et al (2000) How is mechanical ventilation employed in the intensive care unit? An international utilization review. Am J Respir Crit Care Med 161: 1450–1458PubMedGoogle Scholar
  30. 30.
    Masip J, Roque M, Sanchez B, Fernandez R, Subirana M, Exposito JA (2005) Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA 294:3124–3130PubMedCrossRefGoogle Scholar
  31. 31.
    Gunen H, Hacievliyagil SS, Kosar F, et al (2005) Factors affecting survival of hospitalized patients with COPD. Eur Respir J 26:234–241PubMedCrossRefGoogle Scholar
  32. 32.
    Seneff MG, Wagner DP, Wagner RP, Zimmerman JE, Knaus WA (1995) Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease. JAMA 274:1852–1857PubMedCrossRefGoogle Scholar
  33. 33.
    Liu H, Zhang TT, Ye J (2007) Analysis of risk factors for hospital mortality in patients with chronic obstructive pulmonary diseases requiring invasive mechanical ventilation. Chin Med J (Engl )120:287–293Google Scholar
  34. 34.
    Afessa B, Morales IJ, Scanlon PD, Peters SG (2002) Prognostic factors, clinical course, and hospital outcome of patients with chronic obstructive pulmonary disease admitted to an intensive care unit for acute respiratory failure. Crit Care Med 30:1610–1615PubMedCrossRefGoogle Scholar
  35. 35.
    Ram FS, Picot J, Lightowler J, Wedzicha JA (2004) Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev CD004104Google Scholar
  36. 36.
    Girou E, Brun-Buisson C, Taille S, Lemaire F, Brochard L (2003) Secular trends in nosocomial infections and mortality associated with noninvasive ventilation in patients with exacerbation of COPD and pulmonary edema. JAMA 290:2985–2991PubMedCrossRefGoogle Scholar
  37. 37.
    Afessa B, Morales I, Cury JD (2001) Clinical course and outcome of patients admitted to an ICU for status asthmaticus. Chest 120:1616–1621PubMedCrossRefGoogle Scholar
  38. 38.
    Vasilyev S, Schaap RN, Mortensen JD (1995) Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units. An international, multicenter, prospective survey. Chest 107:1083–1088PubMedCrossRefGoogle Scholar
  39. 39.
    Fernandez-Perez ER, Tenad H, Daniels CE, Ryn TH, Gajic O (2006) Ventilator settings and outcome in patients with interstitial lung disease requiring mechanical ventilation in the intensive care unit. Chest 130:152s (abst)Google Scholar
  40. 40.
    Saydain G, Islam A, Afessa B, Ryu JH, Scott JP, Peters SG (2002) Outcome of patients with idiopathic pulmonary fibrosis admitted to the intensive care unit. Am J Respir Crit Care Med 166:839–842PubMedCrossRefGoogle Scholar
  41. 41.
    Ali MI, Fernandez-Perez ER, Pendern S, Brown DR, Wijdicks EF, Gajic O (2006) Mechanical ventilation in patients with Guillain-Barre Syndrome. Respir Care 51:1403–1407PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • H. S. Suri
    • 1
  • G. Li
    • 2
  • O. Gajic
    • 1
  1. 1.Department of Internal Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterUSA
  2. 2.Pulmonary DepartmentGuang An Mem HospitalBeijingChina

Personalised recommendations