After-Crisis Care in Chronic Airway Obstruction

Abstract

Patients with acute respiratory failure from poisonings, acute pneumonias and following surgical procedures, can be expected to recover their previous level of pulmonary function in most cases. Respiratory care, often with a ventilator, provides artificial support for oxygen transport and CO2 removal and as the underlying problem resolves, the weaning period from the respirator is generally not a difficult matter. Also, in states of previous good pulmonary function, extended care will not generally be needed. By contrast, in chronic airway obstruction (CAO), the acute insult leading to acute respiratory failure may be superimposed upon extremely poor pulmonary function and the patient may also require elaborate longterm management in order to leave the hospital and lead a comfortable life at home. It simply does no good to save the patients' lives in the face of a catastrophe, to have him remain ventilator bound, unable to leave the intensive care unit or hospital, or indeed, unable to function adequately at home on discharge. This article explores techniques of care for patients with severe chronic airway obstruction after the emergency is over.