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Respiratory Care: Assessing the Benefits

Respiratory Care: Assessing the Benefits Abstract The treatment of respiratory failure has spawned an empire of intensive-care units, specialized personnel, and sophisticated equipment. Although this growth shows no sign of slowing, some questions have been raised by regulatory agencies, and, more recently, by investigators, as to the impact on patient outcome of this impressive array of hardware.1-3 Perhaps nowhere is this growth more evident than in the exponential increase in ventilator models that has occurred during the past ten years (Figure). From slow and hesitating steps, dating back to biblical times, assisted ventilation began blossoming in the 1930s with negative-pressure ventilators, in response to the respiratory problems of neuromuscular disease. With the waning of these disorders, the therapy for respiratory failure turned to that of obstructive lung disease problems, and, later, to the adult respiratory-distress syndrome. Positive airway pressure and modifications of the pressure waveform (eg, positive end-expiratory pressure [PEEP], intermittent mandatory ventilation [IMV]) were References 1. Davis H II, Lefrak SS, Miller D, et al: Prolonged mechanically assisted ventilation: An analysis of outcome and charges. JAMA 1980;243:43-45.Crossref 2. Schwartz WB, Joskow PL: Medical efficacy versus economic efficiency: A conflict in values. N Engl J Med 1978;229:1462-1464.Crossref 3. Shannon DC, Crone RK, Todres D, et al: Survival, cost of hospitalization and prognosis in infants critically ill with respiratory distress syndrome requiring mechanical ventilation. Crit Care Med 1981;9:94-97.Crossref 4. Springer RR, Stevens PM: The influence of PEEP on survival of patients in respiratory failure: A retrospective analysis. Am J Med 1979;66:196-200.Crossref 5. Schachter EN, Tucker D, Beck GJ: Does intermittent mandatory ventilation accelerate weaning? JAMA 1981;246:1210-1214.Crossref 6. McPherson SP: Respiratory Therapy Equipment , ed 2. St Louis, CV Mosby Co, 1981. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Respiratory Care: Assessing the Benefits

Archives of Internal Medicine , Volume 143 (3) – Mar 1, 1983

Respiratory Care: Assessing the Benefits

Abstract

Abstract The treatment of respiratory failure has spawned an empire of intensive-care units, specialized personnel, and sophisticated equipment. Although this growth shows no sign of slowing, some questions have been raised by regulatory agencies, and, more recently, by investigators, as to the impact on patient outcome of this impressive array of hardware.1-3 Perhaps nowhere is this growth more evident than in the exponential increase in ventilator models that has occurred during the past...
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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350030038006
Publisher site
See Article on Publisher Site

Abstract

Abstract The treatment of respiratory failure has spawned an empire of intensive-care units, specialized personnel, and sophisticated equipment. Although this growth shows no sign of slowing, some questions have been raised by regulatory agencies, and, more recently, by investigators, as to the impact on patient outcome of this impressive array of hardware.1-3 Perhaps nowhere is this growth more evident than in the exponential increase in ventilator models that has occurred during the past ten years (Figure). From slow and hesitating steps, dating back to biblical times, assisted ventilation began blossoming in the 1930s with negative-pressure ventilators, in response to the respiratory problems of neuromuscular disease. With the waning of these disorders, the therapy for respiratory failure turned to that of obstructive lung disease problems, and, later, to the adult respiratory-distress syndrome. Positive airway pressure and modifications of the pressure waveform (eg, positive end-expiratory pressure [PEEP], intermittent mandatory ventilation [IMV]) were References 1. Davis H II, Lefrak SS, Miller D, et al: Prolonged mechanically assisted ventilation: An analysis of outcome and charges. JAMA 1980;243:43-45.Crossref 2. Schwartz WB, Joskow PL: Medical efficacy versus economic efficiency: A conflict in values. N Engl J Med 1978;229:1462-1464.Crossref 3. Shannon DC, Crone RK, Todres D, et al: Survival, cost of hospitalization and prognosis in infants critically ill with respiratory distress syndrome requiring mechanical ventilation. Crit Care Med 1981;9:94-97.Crossref 4. Springer RR, Stevens PM: The influence of PEEP on survival of patients in respiratory failure: A retrospective analysis. Am J Med 1979;66:196-200.Crossref 5. Schachter EN, Tucker D, Beck GJ: Does intermittent mandatory ventilation accelerate weaning? JAMA 1981;246:1210-1214.Crossref 6. McPherson SP: Respiratory Therapy Equipment , ed 2. St Louis, CV Mosby Co, 1981.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1983

References