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Complications of Acute Respiratory Failure

Ann Intern Med. 1969;70(3):487-495. doi:10.7326/0003-4819-70-3-487
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Complications during treatment of 146 patients 239 episodes of acute respiratory failure were studied over a 4-year period. All the patients had previous chronic respiratory insufficiency. Acute necrotizing pneumonia, the hyperventilation alkalosis syndrome, acute myocardial infarction, and cardiac arrhythmias were the commonest fatal complications. Eighteen patients had necrotizing pneumonia; 4 had pneumonia and pulmonary edema; 12 had hyperventilation alkalosis; 8 had errors of airway management; 12 had myocardial infarctions; 11 had ventricular arrhythmias; and 7 others had vascular catastrophies. Frequent sterilization of equipment, aseptic techniques for handling equipment used in airways, and regular bacteriological cultures from equipment were important to decrease nosocomial infections. Frequent careful monitoring of ventilation prevented the alkalosis syndrome. Maintaining good oxygenation and normal hydrogen ion levels in arterial blood reduced the frequency of arrhythmias. Thus, survival of patients can be improved by the prevention or early and effective treatment of complications that cause their premature death.





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