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Anesthesiology1831 papers

Respiratory failure

Last edited: 4/23/2026

Overview

Respiratory failure is a critical condition characterized by the inability of the respiratory system to maintain adequate gas exchange, leading to hypoxemia and hypercapnia. It often necessitates mechanical ventilation and intensive care management.

Diagnosis

  • Clinical Presentation: Hypoxia, hypercapnia, altered mental status, tachypnea, use of accessory muscles 128.
  • Laboratory Tests: Arterial blood gas (ABG) analysis to assess oxygenation and ventilation status 35.
  • Imaging: Chest X-ray or CT to identify underlying causes such as pneumonia, atelectasis, or pulmonary edema 128.
  • Monitoring: Continuous pulse oximetry and capnography for real-time assessment 3233.
  • Management

  • Mechanical Ventilation: Initiate as needed for hypoxemia or hypercapnia, using appropriate modes (e.g., assist-control, pressure support) 128.
  • Sedation: Use protocolized sedation to prevent over-sedation and under-sedation; consider light sedation protocols guided by scales like RASS or COMFORT-B 27212249.
  • Noninvasive Ventilation (NIV): Consider for early intervention in selected patients to avoid intubation 728.
  • Rehabilitation: Early mobilization and physiotherapy to facilitate weaning from mechanical ventilation 2932.
  • Monitoring and Adjustment: Regularly assess patient-ventilator asynchrony and adjust settings accordingly 622.
  • Special Populations

  • Pediatrics: Focus on appropriate sedation protocols and noninvasive support strategies; monitor for unique complications like dysrhythmias 94447.
  • Elderly: Consider comorbidities and frailty; prioritize light sedation and early mobilization to reduce complications 38.
  • Comorbidities: Tailor management based on coexisting conditions (e.g., cardiac issues requiring ECMO) 12132555.
  • Key Recommendations

  • Initiate Mechanical Ventilation Early for Severe Respiratory Failure: Ensure adequate oxygenation and ventilation 128 (Evidence: Strong).
  • Implement Protocolized Sedation to Optimize Sedation Levels: Use validated scales to guide sedation depth 2721 (Evidence: Strong).
  • Consider Early Noninvasive Ventilation to Prevent Intubation: Evaluate suitability for NIV in appropriate patients 728 (Evidence: Moderate).
  • Regularly Monitor and Adjust Ventilator Settings for Asynchrony: Use waveform analysis to identify and correct patient-ventilator interactions 622 (Evidence: Moderate).
  • Promote Early Mobilization and Rehabilitation: Facilitate physical therapy to aid in weaning from mechanical ventilation 2932 (Evidence: Moderate).
  • References

    Showing 100 most recent of 512 indexed papers.

    1 Ahmed MK, Alman KA, Rashid M, Muhib F, Rahman S, Noor N et al.. OxyJet CPAP: an electricity-free low-cost emergency respiratory support device. Biomedical engineering online 2026. link 2 Li J, Li H, Hou X, Shi Y, Zhao J. Evaluation of nurse-led sedation protocols on clinical outcomes in mechanically ventilated adults within intensive care units: A meta-analysis of randomized controlled trials. Advances in clinical and experimental medicine : official organ Wroclaw Medical University 2026. link 3 Mousavinejad SN, Lachouri R, Bahadorzadeh M, Khatami SH. Artificial intelligence for arterial blood gas interpretation. Clinica chimica acta; international journal of clinical chemistry 2026. link 4 Ferguson TL, Gilbert CR. Interventional Pulmonology Procedures in the Intensive Care Unit. Clinics in chest medicine 2025. link 5 Gün M. AI-Assisted Blood Gas Interpretation: A Comparative Study With an Emergency Physician. The American journal of emergency medicine 2025. link 6 Bogale W, Kefyalew M, Debebe F. Emergency and critical care medicine residents' competency to identify patient ventilator asynchrony using a mechanical ventilator waveform analysis in Addis Ababa, Ethiopia: a multicenter cross-sectional study. BMC medical education 2025. link 7 Lewis K, Hassall K, Sharif S. Sedation and Noninvasive Positive Pressure Ventilation-Where are We now? A Narrative Review. Critical care clinics 2025. link 8 Vollbrecht H, Patel BK. Management of sedation during weaning from mechanical ventilation. Current opinion in critical care 2025. link 9 Lee S, Marshall J, Clarke M, Smith C. 'They don't know what to do with our children': Experiences and views on feeding and swallowing from parents of children who use long-term ventilation. Journal of child health care : for professionals working with children in the hospital and community 2025. link 10 Oliver DP, Mayahara M, Donehower A, Benson JJ, Paget D, Makinde KW et al.. Sights and Sounds of Respiratory Changes During Hospice Death Vigils: Hospice Caregivers Experience. Journal of pain and symptom management 2025. link 11 Schenck CS, Chouairi F, Dudzinski DM, Miller PE. Noninvasive Ventilation in the Cardiac Intensive Care Unit. Journal of intensive care medicine 2025. link 12 Thiara S, Willms AJ, Tran A, Mitra AR, Sekhon M, Hoiland R et al.. Prognostic Factors Associated With Intracranial Hemorrhage and Ischemic Stroke During Venovenous Extracorporeal Membrane Oxygenation: A Systematic Review. Critical care medicine 2025. link 13 Doyle AJ, Retter A, Parmar K, Mayger K, Barrett N, Camporota L et al.. Temporal changes in markers of coagulation and fibrinolysis in adults during extracorporeal membrane oxygenation. Perfusion 2025. link 14 Hammash MH, Moser DK. Occurrence of Dysrhythmias During Ventilatory Weaning and Its Association With Length of Mechanical Ventilation and In-hospital Complications. The Journal of cardiovascular nursing 2025. link 15 Carmona CA, Bain J, Karam O. Concordance and discordance of anticoagulation assays in children supported by ECMO: The truth is out there. Perfusion 2025. link 16 Miyata A, Doijiri R, Takikawa K, Sonoda T, Yamazaki N, Egashira S et al.. Acute Respiratory Failure Caused by Lateral Medullary Infarction - An Unknown Condition with Varied Etiology and Requiring Special Vigilance: A Case Series. Internal medicine (Tokyo, Japan) 2025. link 17 Supady A, Dudek L, Staudacher DL, Wengenmayer T, Rilinger J. Mode of death after venovenous extracorporeal membrane oxygenation - a retrospective single-center analysis. Respiratory medicine 2025. link 18 Baker A, Shah E, Ouyang A, Silver M, Tomko SR, Guilliams K et al.. Electroencephalographic Findings Add Prognostic Value to Clinical Features Associated with Mortality on Venoarterial Extracorporeal Support. Neurocritical care 2025. link 19 Jolink FEJ, Onrust M, Dos Reis Miranda D, Mandigers L, Delnoij T, Maas JJ et al.. Five Years After Extracorporeal Membrane Oxygenation: A Prospective Cohort Study of Health-Related Quality of Life and Patient Outcomes. Critical care medicine 2025. link 20 Barker AK, Valley TS, Kenes MT, Sjoding MW. Early Deep Sedation Practices Worsened During the Pandemic Among Adult Patients Without COVID-19: A Retrospective Cohort Study. Chest 2024. link 21 Vallabhaneni P, Khera D, Choudhary B, Singh S, Singh K, Didel S et al.. Protocolized Sedation Utilizing COMFORT-B Scale versus Non-protocol-directed Sedation in Mechanically Ventilated Children - An Open-label, Randomized Controlled Trial. Indian journal of pediatrics 2024. link 22 Xu J, He Q, Wang M, Wang Z, Wu W, Li L et al.. Early deep-to-light sedation versus continuous light sedation for ICU patients with mechanical ventilation: A cohort study. Anaesthesia, critical care & pain medicine 2024. link 23 Gao X, Yang X, Tang Y, Fang X, Yuan Y, Qi H et al.. Fospropofol disodium versus propofol for long-term sedation during invasive mechanical ventilation: A pilot randomized clinical trial. Journal of clinical anesthesia 2024. link 24 Boncyk C, Devlin JW, Faisal H, Girard TD, Hsu SH, Jabaley CS et al.. INhaled Sedation versus Propofol in REspiratory failure in the Intensive Care Unit (INSPiRE-ICU1): protocol for a randomised, controlled trial. BMJ open 2024. link 25 Reid TD, Crespo Regalado R, Carlson R, Schneider A, Boone JS, Hockran S et al.. Outcomes in Obese Adult Veno-Venous Extracorporeal Membrane Oxygenation: A Systematic Review. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2024. link 26 van Galen DJM, Meinders Q, Halfwerk FR, Arens J. ECMOve: A Mobilization Device for Extracorporeal Membrane Oxygenation Patients. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2024. link 27 Bartlett RH. The Story of ECMO. Anesthesiology 2024. link 28 Boscolo A, Pettenuzzo T, Sella N, Zatta M, Salvagno M, Tassone M et al.. Noninvasive respiratory support after extubation: a systematic review and network meta-analysis. European respiratory review : an official journal of the European Respiratory Society 2023. link 29 Wu RY, Yeh HJ, Chang KJ, Tsai MW. Effects of different types and frequencies of early rehabilitation on ventilator weaning among patients in intensive care units: A systematic review and meta-analysis. PloS one 2023. link 30 Li W, Zhang Y, Wang Z, Jia D, Zhang C, Ma X et al.. The risk factors of reintubation in intensive care unit patients on mechanical ventilation: A systematic review and meta-analysis. Intensive & critical care nursing 2023. link 31 Assouline B, Combes A, Schmidt M. Setting and Monitoring of Mechanical Ventilation During Venovenous ECMO. Critical care (London, England) 2023. link 32 Rosenberg K. No Advantage for Early Active Mobilization During Mechanical Ventilation. The American journal of nursing 2023. link 33 Abundes-Velasco A, Sánchez-Pérez E, Jiménez-Rodríguez GM, Molina-Méndez FJ, Herrera-Elizalde R, Pulido-Zamudio T et al.. Evaluation of an automatized AMBU ESSI-1 INC designed at the Instituto Nacional de Cardiología Ignacio Chávez. Archivos de cardiologia de Mexico 2023. link 34 Mehrzai P, Höfeler T, Ebenebe CU, Moll-Khosrawi P, Demirakça S, Vettorazzi E et al.. Pilot study of an interprofessional pediatric mechanical ventilation educational initiative in two intensive care units. BMC medical education 2023. link 35 Rocca E, Zanza C, Longhitano Y, Piccolella F, Romenskaya T, Racca F et al.. Lung Ultrasound in Critical Care and Emergency Medicine: Clinical Review. Advances in respiratory medicine 2023. link 36 Mehta AB, Matlock DD, Shorr AF, Douglas IS. Healthcare Trajectories and Outcomes in the First Year After Tracheostomy Based on Patient Characteristics. Critical care medicine 2023. link 37 Schmitt CJ, Mattson AE, Brown CS, Mara KC, Cabrera D, Sandefur BJ et al.. The incidence of cardiovascular instability in patients receiving various vasopressor strategies for peri-intubation hypotension. The American journal of emergency medicine 2023. link 38 Chung Y, Garden FL, Marks GB, Vedam H. Causes of hypercapnic respiratory failure and associated in-hospital mortality. Respirology (Carlton, Vic.) 2023. link 39 Lichtsinn K, Sehgal I, Wilson A. Asystole in 2 Pediatric Patients During Dexmedetomidine Infusion. Journal of pharmacy practice 2023. link 40 Montalbaron MB, Tian L, Yu VX, Awad MI, Bensoussan Y, Leber WS et al.. Multi-institutional search for patient factors associated with adverse events following tracheotomy. American journal of otolaryngology 2023. link 41 Pollack BE, Kirsch R, Chapman R, Hyslop R, MacLaren G, Barbaro RP. Extracorporeal Membrane Oxygenation Then and Now; Broadening Indications and Availability. Critical care clinics 2023. link 42 Murray EK, You CX, Verghese GC, Krauss BS, Heldt T. Low-Order Mechanistic Models for Volumetric and Temporal Capnography: Development, Validation, and Application. IEEE transactions on bio-medical engineering 2023. link 43 Li P, Sun Z, Xu J. Unplanned extubation among critically ill adults: A systematic review and meta-analysis. Intensive & critical care nursing 2022. link 44 Chen TJ, Chung YW, Chen PY, Hu SH, Chang CC, Hsieh SH et al.. Effects of daily sedation interruption in intensive care unit patients undergoing mechanical ventilation: A meta-analysis of randomized controlled trials. International journal of nursing practice 2022. link 45 Trivedi V, Chaudhuri D, Jinah R, Piticaru J, Agarwal A, Liu K et al.. The Usefulness of the Rapid Shallow Breathing Index in Predicting Successful Extubation: A Systematic Review and Meta-analysis. Chest 2022. link 46 Quinn L, Veenith T, Bion J, Hemming K, Whitehouse T, Lilford R. Bayesian analysis of a systematic review of early versus late tracheostomy in ICU patients. British journal of anaesthesia 2022. link 47 Magge A, Oberg CL. Interventional Pulmonology and the Esophagus: Tracheostomy and Percutaneous Endoscopic Gastrostomy Placement. Seminars in respiratory and critical care medicine 2022. link 48 Kovalsky D, Roberts MB, Freeze B, Moss J, Jones CW, Kilgannon H et al.. Posttraumatic stress disorder symptoms after respiratory and cardiovascular emergencies predict risk of hospital readmission: A prospective cohort study. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2022. link 49 Brown C, Marotta PJ, Riker RR, Eldridge AD, Fraser GL, May TL. Prospective Validation of Sedation Scale Scores That Identify Light Sedation: A Pilot Study. American journal of critical care : an official publication, American Association of Critical-Care Nurses 2022. link 50 Seyller N, Makic MBF. Clinical Nurse Specialist Practice: Impact on Improving Sedation Practice in Critical Care. Clinical nurse specialist CNS 2022. link 51 Brown J, Warnock B, Turk E, Hobson MJ, Friedman ML, Gray BW. Open abdomen during extracorporeal membrane oxygenation is a safe and effective treatment for abdominal compartment syndrome. Journal of pediatric surgery 2022. link 52 Hiramatsu T, Shimizu S, Koga H. Prognostic factors in patients treated with extracorporeal membrane oxygenation and continuous renal replacement therapy. Perfusion 2022. link 53 Othman S, Azoury SC, DiBardino D, Adams DM, Itkin M, Kovach SJ. Respiratory Failure in Noonan Syndrome Treated by Microsurgical Thoracic Duct-Venous Anastomosis. The Annals of thoracic surgery 2022. link 54 Barrett CD, Moore HB, Moore EE, Wang J, Hajizadeh N, Biffl WL et al.. Study of Alteplase for Respiratory Failure in SARS-CoV-2 COVID-19: A Vanguard Multicenter, Rapidly Adaptive, Pragmatic, Randomized Controlled Trial. Chest 2022. link 55 Amin RM, Chaudhry YP, Rao SS, Puvanesarajah V, Best MJ, Etchill E et al.. Extremity fasciotomy for patients on extracorporeal membrane oxygenation is independently associated with inpatient mortality. Orthopaedics & traumatology, surgery & research : OTSR 2022. link 56 Li C, Pajoumand M, Lambert K, Najia L, Bathula AL, Mazzeffi MA et al.. New-Onset Atrial Arrhythmias Are Independently Associated With In-Hospital Mortality in Veno-Venous Extracorporeal Membrane Oxygenation. Journal of cardiothoracic and vascular anesthesia 2022. link 57 Ryoo J, Huh J, Cho HS, Kim JJ, Kim SC, Lee J. Case report: atrial septostomy as a bridge to lung transplantation in a patient with venovenous extracorporeal membrane oxygenation. Medicine 2022. link 58 Papadimas E, Leow L, Tan YK, Shen L, Ramanathan K, Choong AMTL et al.. Centrifugal and Roller Pumps in Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis of Clinical Outcomes. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2022. link 59 Foong TW, Ramanathan K, Chan KKM, MacLaren G. Extracorporeal Membrane Oxygenation During Adult Noncardiac Surgery and Perioperative Emergencies: A Narrative Review. Journal of cardiothoracic and vascular anesthesia 2021. link 60 Rai B, Wang LC, Pandit S, Handfield T, So CK. Awareness of ethical dilemmas enhances public support for the principle of saving more lives in the United States: A survey experiment based on ethical allocation of scarce ventilators. Social science & medicine (1982) 2021. link 61 Prada G, Vieillard-Baron A, Martin AK, Hernandez A, Mookadam F, Ramakrishna H et al.. Tracheal, Lung, and Diaphragmatic Applications of M-Mode Ultrasonography in Anesthesiology and Critical Care. Journal of cardiothoracic and vascular anesthesia 2021. link 62 See KC, Sahagun J, Cove M, Sum CL, Garcia B, Chanco D et al.. Managing patient-ventilator asynchrony with a twice-daily screening protocol: A retrospective cohort study. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses 2021. link 63 Wong AI, Charpignon M, Kim H, Josef C, de Hond AAH, Fojas JJ et al.. Analysis of Discrepancies Between Pulse Oximetry and Arterial Oxygen Saturation Measurements by Race and Ethnicity and Association With Organ Dysfunction and Mortality. JAMA network open 2021. link 64 McClelland M, McClelland S. Case of a 21-year-old man with persistent lung collapse leading to a pericardectomy linked to vape use. Heart & lung : the journal of critical care 2021. link 65 Stefan MS, Priya A, Pekow PS, Steingrub JS, Hill NS, Lagu T et al.. A scoring system derived from electronic health records to identify patients at high risk for noninvasive ventilation failure. BMC pulmonary medicine 2021. link 66 Hayes MM, Fallon BP, Barbaro RP, Manusko N, Bartlett RH, Toomasian JM. Membrane Lung and Blood Pump Use During Prolonged Extracorporeal Membrane Oxygenation: Trends From 2002 to 2017. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2021. link 67 Contini M, Angelucci A, Aliverti A, Gugliandolo P, Pezzuto B, Berna G et al.. Comparison between PtCO. Sensors (Basel, Switzerland) 2021. link 68 Rafiq MU, Valchanov K, Vuylsteke A, Taghavi FJ, Iyer SB, Sudarshan CD et al.. Regional extracorporeal membrane oxygenation retrieval service during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic: an interdisciplinary team approach to maintain service provision despite increased demand. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 2020. link 69 Broman LM, Dirnberger DR, Malfertheiner MV, Aokage T, Morberg P, Næsheim T et al.. International Survey on Extracorporeal Membrane Oxygenation Transport. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2020. link 70 Erell Y, Dagan O, Shostak E, Manor O, Amir G, Frenkel G et al.. Pediatric Extracorporeal Membrane Oxygenation Reach-Out Program: Successes and Insights. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2020. link 71 Skoog H, Withrow K, Jeyarajan H, Greene B, Batra H, Cox D et al.. Tracheotomy in the SARS-CoV-2 pandemic. Head & neck 2020. link 72 Koonin LM, Pillai S, Kahn EB, Moulia D, Patel A. Strategies to Inform Allocation of Stockpiled Ventilators to Healthcare Facilities During a Pandemic. Health security 2020. link 73 Roberts J, Powell J, Begbie J, Siou G, McLarnon C, Welch A et al.. Pediatric tracheostomy: A large single-center experience. The Laryngoscope 2020. link 74 Muñoz-Bonet JI, López-Prats JL, Flor-Macián EM, Cantavella T, Bonet L, Domínguez A et al.. Usefulness of telemedicine for home ventilator-dependent children. Journal of telemedicine and telecare 2020. link 75 Barbosa TP, Beccaria LM, Bastos AS, Silva DCD. Association between sedation level and mortality of intensive care patients on mechanical ventilation. Revista da Escola de Enfermagem da U S P 2020. link 76 Long L, Ren S, Gong Y, Zhao H, He C, Shen L et al.. Different depths of sedation versus risk of delirium in adult mechanically ventilated patients: A systematic review and meta-analysis. 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Current practice and perceptions regarding pain, agitation and delirium management in patients receiving venovenous extracorporeal membrane oxygenation. Journal of critical care 2019. link 82 Fuller BM, Roberts BW, Mohr NM, Knight WA, Adeoye O, Pappal RD et al.. The ED-SED Study: A Multicenter, Prospective Cohort Study of Practice Patterns and Clinical Outcomes Associated With Emergency Department SEDation for Mechanically Ventilated Patients. Critical care medicine 2019. link 83 Frawley A, Hickey J, Weaver C, Williams JP, Szakmany T. Introducing a new sedation policy in a large district general hospital: before and after cohort analysis. Anaesthesiology intensive therapy 2019. link 84 Bodnar J. Terminal Withdrawal of Mechanical Ventilation: A Hospice Perspective for the Intensivist. Journal of intensive care medicine 2019. link 85 Smith TA, Ingham JM, Jenkins CR. Respiratory Failure, Noninvasive Ventilation, and Symptom Burden: An Observational Study. Journal of pain and symptom management 2019. link 86 Gupta P, Gossett JM, Kofos D, Rettiganti M. Creation of an empiric tool to predict ECMO deployment in pediatric respiratory or cardiac failure. Journal of critical care 2019. link 87 Sanaiha Y, Bailey K, Downey P, Seo YJ, Aguayo E, Dobaria V et al.. Trends in mortality and resource utilization for extracorporeal membrane oxygenation in the United States: 2008-2014. Surgery 2019. link 88 Kashlan KN, Williams AM, Chang SS, Yaremchuk KL, Mayerhoff R. Analysis of patient factors associated with 30-day mortality after tracheostomy. The Laryngoscope 2019. link 89 Soquet J, Chiletti R, Horton S, Konstantinov IE, Brink J, Brizard CP et al.. Dismal Outcomes of Second-Run Extracorporeal Life Support in the Paediatric Population. Heart, lung & circulation 2019. link 90 Cohen O, Shapira-Galitz Y, Shnipper R, Stavi D, Halperin D, Adi N et al.. Outcome and survival following tracheostomy in patients ≥ 85 years old. 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Oxygen Treatment in Intensive Care and Emergency Medicine. Deutsches Arzteblatt international 2018. link 95 Mehrabi A, Dillon P, Kelly K, Hitchins K, Malatino E, Gorman S et al.. Experimental studies on performance of ventilators stored in the Strategic National Stockpile. Journal of emergency management (Weston, Mass.) 2018. link 96 Lizza BD, Jagow B, Hensler D, Cooper CJ, Short EJ, Maas MB et al.. Impact of Multiple Daily Clinical Pharmacist-Enforced Assessments on Time in Target Sedation Range. Journal of pharmacy practice 2018. link 97 Humphrey M, Everhart S, Kosmisky D, Anderson WE. An evaluation of patient-specific characteristics on attainment of target sedation in an intensive care unit. Heart & lung : the journal of critical care 2018. link 98 Taffarel P, Bonetto G, Jorro Barón F, Meregalli C. Sedation and analgesia in patients on mechanical ventilation in pediatric intensive care units in Argentina. 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    Original source

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      OxyJet CPAP: an electricity-free low-cost emergency respiratory support device.Ahmed MK, Alman KA, Rashid M, Muhib F, Rahman S, Noor N et al. Biomedical engineering online (2026)
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      Evaluation of nurse-led sedation protocols on clinical outcomes in mechanically ventilated adults within intensive care units: A meta-analysis of randomized controlled trials.Li J, Li H, Hou X, Shi Y, Zhao J Advances in clinical and experimental medicine : official organ Wroclaw Medical University (2026)
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      AI-Assisted Blood Gas Interpretation: A Comparative Study With an Emergency Physician.Gün M The American journal of emergency medicine (2025)
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      Sedation and Noninvasive Positive Pressure Ventilation-Where are We now? A Narrative Review.Lewis K, Hassall K, Sharif S Critical care clinics (2025)
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      Electroencephalographic Findings Add Prognostic Value to Clinical Features Associated with Mortality on Venoarterial Extracorporeal Support.Baker A, Shah E, Ouyang A, Silver M, Tomko SR, Guilliams K et al. Neurocritical care (2025)
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