Acute respiratory failure: Back to the roots!

Abstract

Hypoxic respiratory failure is one of the most commonest disorders leading to intensive care unit (ICU) admission and also a common reason for the deterioration of patients already treated in the ICU. It is a very serious condition associated with significant mortality [1, 2]. In recent decades, research and scientific attention has focused nearly exclusively on the pathophysiology and treatment of established causes of hypoxic respiratory failure such distress syndrome (ARDS) [1, 2]. Therefore, our diagnostic approach to patients with hypoxic respiratory failure has remained both largely unchanged and poorly validated. This is a dilemma because diagnostic uncertainty is very common. The severity of disease and the requirement for immediate ventilatory support often limit our ability to obtain a detailed patient history and physical examination. Chest X-ray is helpful but also associated with important limitations [3].