Respiratory Insufficiency (Respiratory Failure)

Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)

Also Known As:

Respiratory Failure; Ventilatory Depression; Depressions, Ventilatory; Failure, Hypercapnic Respiratory; Failure, Hypoxemic Respiratory; Failure, Respiratory; Hypercapnic Respiratory Failures; Hypoxemic Respiratory Failures; Respiratory Failure, Hypercapnic; Respiratory Failure, Hypoxemic; Respiratory Failures; Acute Hypercapnic Respiratory Failure; Acute Hypoxemic Respiratory Failure; Hypercapnic Acute Respiratory Failure; Hypercapnic Respiratory Failure; Hypoxemic Acute Respiratory Failure; Hypoxemic Respiratory Failure; Respiratory Depression

Networked: 25454 relevant articles (1257 outcomes, 1858 trials/studies)

Relationship Network

Disease Context: Research Results

Respiratory Tract Diseases: 6015
- Respiration Disorders: 18
  - Respiratory Insufficiency: 25454

Related Diseases

1.	Chronic Obstructive Pulmonary Disease (COPD)
2.	COVID-19
3.	Pneumonia (Pneumonitis)
4.	Pain (Aches)
5.	Respiratory Distress Syndrome (Acute Respiratory Distress Syndrome)

Experts

1.	Dahan, Albert: 55 articles (11/2022 - 02/2003)
2.	Thille, Arnaud W: 54 articles (01/2022 - 05/2009)
3.	Brochard, Laurent: 49 articles (11/2021 - 08/2002)
4.	Nava, Stefano: 45 articles (10/2022 - 05/2002)
5.	Frat, Jean-Pierre: 43 articles (01/2022 - 08/2014)
6.	Azoulay, Elie: 42 articles (03/2022 - 05/2008)
7.	Brodie, Daniel: 39 articles (10/2022 - 11/2011)
8.	Antonelli, Massimo: 38 articles (01/2022 - 01/2003)
9.	Windisch, Wolfram: 37 articles (01/2022 - 08/2003)
10.	Pesenti, Antonio: 35 articles (01/2022 - 02/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Respiratory Insufficiency:

1.	Oxygen (Dioxygen)IBA 01/01/2021 - "Although high-flow nasal oxygen has shown promising results in patients with de-novo acute respiratory failure, further large clinical trials are needed to determine the best oxygenation strategy. " 01/01/2022 - "High flow nasal oxygen (HFNO) is proven to be effective in non-COVID-19 hypoxemic respiratory failure. " 01/01/2022 - "Although high-flow nasal oxygen has gained major popularity in ICUs due to its simplicity of application, good comfort for patients, efficiency in improving oxygenation and promising results in patients with acute hypoxemic respiratory failure, further large clinical trials are needed to confirm its superiority over standard oxygen. " 08/01/2021 - "Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS." 01/01/2015 - "There was a significantly greater number of patients with previously confirmed chronic respiratory failure using long-term oxygen theraphy in A group (p = 0.029). "
2.	Opioid Analgesics (Opioids)IBA 11/01/2003 - "The efficacy of opioids is well established, but there are concerns about dependency, respiratory depression and side-effects, which patients often find intolerable. " 01/01/2021 - "While the majority have not undergone rigorous scientific evaluation via randomized controlled trials, several AI interventions showed promise in aiding the identification of escalating opioid use patterns, informing the treatment of OUD, and detecting opioid-induced respiratory depression. " 01/01/2022 - "Experiments with Oprm1-deleted knockout (KO) mice undertaken to determine which sites are necessary for the induction of opioid-induced respiratory depression (OIRD) showed that the pre-Bötzinger complex (preBötC) and the pontine Kölliker-Fuse nucleus (KF) contribute equally to OIRD but RD was not totally eliminated. " 10/01/2020 - "Little is known about patients who are likely to experience opioid-induced respiratory depression events on the general care floor and may benefit from improved monitoring and early intervention. " 11/01/2023 - "Our objectives were to (1) determine the feasibility of recruiting socioeconomically disadvantaged and racially diverse middle aged and older adult populations for a study seeking to identify risk factors for opioid-related falls and other serious adverse effects and (2) explore potential associations between the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) risk class and other patient factors with falls and serious opioid adverse effects. "
3.	Surface-Active Agents (Surfactants)IBA 01/21/2009 - " ability to give multiple doses of surfactant to infants with ongoing respiratory insufficiency leads to improved clinical outcome and appears to be the most effective treatment policy." 01/01/2000 - "The ability to give multiple doses of surfactant to infants with ongoing respiratory insufficiency leads to improved clinical outcome and appears to be the most effective treatment policy." 03/01/1994 - "The efficacy of exogenous surfactant can be improved by increasing the dosage of surfactant and by administration of surfactant very early in respiratory failure." 11/01/2023 - "Beneficial treatment effects might be higher than reported in the literature when targeting this approach to preterm infants suffering from respiratory failure primarily due to surfactant deficiency. " 06/01/1992 - "The results of this pilot study suggest that the combination of HFJV and exogenous surfactant replacement may be effective in treating infants with more severe respiratory failure, and indicate the need for more extensive controlled investigations."
4.	Nitric Oxide (Nitrogen Monoxide)FDA Link 07/18/2007 - "Inhaled nitric oxide (iNO) has been proven to be effective in term infants with hypoxic respiratory failure. " 01/25/2006 - "Inhaled nitric oxide has been proven effective in term infants with hypoxic respiratory failure. " 01/01/2001 - "Inhaled nitric oxide has been proven effective in term infants with hypoxic respiratory failure. " 01/01/2001 - "Inhaled nitric oxide has been proven effective in term infants with hypoxic respiratory failure. " 01/01/2003 - "Initial studies examining the effect of inhaled nitric oxide in respiratory failure demonstrated transient improvement in oxygenation but did not examine mortality or other significant morbidity outcomes. "
5.	Adrenal Cortex Hormones (Corticosteroids)IBA 06/19/2020 - "A short course of systemic corticosteroids among inpatients with SARS-CoV-2 with hypoxic respiratory failure was well tolerated, and most patients had improved outcomes. " 06/08/2016 - "However, no large clinical studies have investigated the prognosis or efficacy of combined treatments including high-dose corticosteroids in IPF patients with a rapid progression of respiratory failure. " 05/01/1995 - "carinii-related respiratory failure, only adjunctive corticosteroids were associated with a significant improvement in survival to successful removal of the tracheal tube, from a historical rate of 11% to 91%." 02/18/2016 - "The respiratory failure improved with time, using corticosteroids, and the veno-venous ECMO helped in stabilisation of the patient in the setting of profound hypoxaemia. " 09/01/2010 - "Of the seven patients who developed ILD, six were treated with corticosteroids, and the ILD improved in three of them, but the other three patients died of respiratory failure. "
6.	Morphine (MS Contin)FDA LinkGeneric 03/01/1993 - "When EA was administered together with morphine, peristalsis of the duodenum was much less inhibited (P < 0.05, vs morphine alone group), but no significant improvement of respiratory depression was noticed (P > 0.05), nor obvious change of arterial pressure in both groups. " 12/01/1996 - "However, NOS inhibitor treatment is more effective in suppressing morphine-induced ventilatory depression when given before, rather than after, morphine administration. " 11/01/2022 - "This retrospective single-center study of 4963 patients evaluated the frequency of respiratory depression after neuraxial morphine administration in a post-cesarean delivery population. " 10/01/2022 - "In this study we sought to define the roles of central versus peripheral CB1R activation on respiratory depression alone and in combination with morphine using whole body plethysmography. " 12/01/2021 - "Patients receiving intrathecal morphine were no more likely to have respiratory depression, the risk ratio (95%CI) being 0.9 (0.5-1.7), p = 0.78 (16 trials; 1173 patients; high-quality evidence). "
7.	Naloxone (Narcan)FDA LinkGeneric 01/01/2017 - "Naloxone was equally effective in both OXY-dKLH and control groups, providing complete and rapid reversal of respiratory depression. " 12/01/1980 - "Respiratory depression was treated successfully with naloxone." 09/05/2014 - "While, a single injection of naloxone (150.0 μg/kg, i.m.) only achieved partial remission of respiratory depression. " 10/01/2021 - "This study found that n=22/100 naloxone administrations were inappropriate, often given to patients who were not suffering from respiratory depression (n=11/22). Positive pressure ventilation (PPV) was not administered prior to naloxone in n=56/100 cases, of which n=42/100 had an inadequate respiratory effort documented. " 10/01/2021 - "This study showed that EMS providers in Los Angeles County, California (USA) frequently administered naloxone to individuals without respiratory depression."
8.	Fentanyl (Sublimaze)FDA LinkGeneric 02/01/2019 - "However, the risk of the SAE respiratory depression was significantly greater when fentanyl was used off-label by both age and indication (OR 5.05, 95% CI 1.08-23.56, p = 0.044). " 11/01/2019 - "Study 2 was an experimental study on the effect of intravenous fentanyl on antinociception and respiratory depression in healthy volunteers. " 01/01/2017 - "This study investigated the effect of pregnancy on fentanyl-induced respiratory depression. " 09/01/2013 - "An explorative study on the effects of fentanyl on antinociception and respiratory depression was performed to construct fentanyl risk-benefit (utility) functions. " 03/01/2004 - "The aim of this study was to evaluate the validity of the SCSB compared with the respiratory inductive plethysmograph (RIP) using a fentanyl-induced respiratory depression model. "
9.	Carbon DioxideIBA 10/01/2011 - "In contrast, arteriovenous carbon dioxide removal (AVCO(2)R) is a novel strategy that has been shown to be highly effective in adults with acute respiratory failure. " 01/01/2020 - "It is demonstrated that LVRC treatment caused significant decreases in carbon dioxide levels as well as causing improvement in life quality and respiratory function tests in the patients with hypercapnic respiratory failure." 12/01/2015 - "The KD may significantly decrease carbon dioxide body stores, which may theoretically be beneficial for patients with increased carbon dioxide arterial partial pressure due to respiratory insufficiency or failure." 06/01/2006 - "The 6-month NNPPV treatment significantly decreased the partial pressure of carbon dioxide and improved daytime respiratory muscle function, thus contributing to exercise-capacity increase in patients with chronic respiratory failure." 01/01/2019 - "With the focus on patients with persistent hypercapnic respiratory failure in the recovery phase following a life-threatening exacerbation combined with targeted reduction in carbon dioxide, HOT and HMV (HOT-HMV) was shown to be clinically effective in reducing the time to readmission or death and cost effective in both the United Kingdom and United States healthcare systems. "
10.	Analgesics (Analgesic Drugs)IBA 01/01/1976 - "is effective in the rapid and definite reversal of the respiratory depression caused by the analgesics. " 01/01/2022 - "Our results validated the analgesic efficacy of low-to-medium dose ITM for patients receiving cardiac surgery without increasing the risk of respiratory depression." 07/01/2007 - "However, the study protocol did not allow for the use of nonsteroidal antiinflammatory drugs, used various postoperative analgesics, and monitoring and treatment of respiratory depression were not standardized. " 08/01/2023 - "The 150 mcg ITM dose provided good analgesic effects with longer duration and was not associated with respiratory depression." 01/01/2022 - "Most of the above substances had been developed in 1950s to 1970s, but had never been used as analgesic medicines, because of their severe adverse effects, such as respiratory depression, physical dependence, and resulting deaths. "

Therapies and Procedures

1.	Therapeutics 09/01/2010 - "NIMV therapy has some important and significant benefits in patients with hypercapnic chronic respiratory failure. " 07/01/1998 - "Although his condition had been septic and he had experienced renal and respiratory failure, he achieved a complete remission after 140 days without additional therapy. " 10/13/2022 - "In total, 22 studies were included in the synthesis and four themes were generated: NARS as a buoy (NARS can represent hope and relief from the symptoms of respiratory failure), NARS as an anchor (NARS brings significant treatment burden), Impact on Staff (uncertainty over the balance of benefit and burden as well as complex patient care drives distress among staff providing care) and the Process of Withdrawal (withdrawal of therapy felt to be futile exists as discrete event in patient care but is otherwise poorly defined). " 11/01/2021 - "Despite the potential limitations of FAPP, which detects a defined number of pathogens, its advantages of rapid detection combined with predictive information regarding the antimicrobial resistance of pathogens through the detection of some relevant markers of resistance could be very useful for establishing empirical targeted therapy for the treatment of patients with respiratory failure. " 02/01/2019 - "LUS can be beneficial for evaluating children with respiratory failure that are admitted in pediatric intensive care unit (PICU) and may contribute towards appropriate therapy for children. "
2.	Artificial Respiration (Mechanical Ventilation) 01/01/2014 - "Non-invasive mechanical ventilation provides early improvement in most of the patients with acute hypercapnic respiratory failure. " 01/01/2011 - "Non-invasive mechanical ventilation is considered highly effective for treating chronic respiratory failure. " 11/01/1994 - "The following conclusions are drawn from critical evaluation of the collected data: (1) Closed system positive pressure mechanical ventilation applied at mild to moderate levels of intensity is a safe and effective method for augmenting deficient blood gas exchange in most patients who are in acute respiratory failure. " 06/01/1997 - "Respiratory failure developed within 54 h and CO2 could not be eliminated, even by very invasive mechanical ventilation. " 06/01/2011 - "The aim was to study the efficacy of rescue High Frequency Oscillatory Ventilation (HFOV) in improving the oxygenation and ventilation in neonates with acute respiratory failure after failing Conventional Mechanical Ventilation (CMV). "
3.	Noninvasive Ventilation 01/01/2023 - "In a curative approach, HFNO seems of interest following cardiac or thoracic surgery but has not been evaluated in respiratory failure subsequent to abdominal surgery, in which case noninvasive ventilation remains the gold standard. " 01/01/2009 - "During noninvasive ventilation (NIV) for acute respiratory failure, the patient's comfort may be less important than the efficacy of the treatment. " 07/01/2008 - "Noninvasive ventilation (NIV) has proven to be a safe and effective technique in the treatment of respiratory failure complicating various medical and surgical diseases. " 01/01/2015 - "There are only a few studies in English that describe severe respiratory failure treated with non-invasive ventilation, but all of them have had good outcomes." 05/01/2002 - "Several randomized controlled trials have shown that use of noninvasive ventilation to achieve earlier extubation in difficult-to-wean patients or in patients who develop respiratory failure after apparently successful extubation can result in reduced periods of endotracheal intubation and complication rates and improved survival. "
4.	Positive-Pressure Respiration (Positive End-Expiratory Pressure) 10/01/2005 - "In particular, noninvasive positive pressure ventilation (NIPPV) is effective in resolving respiratory failure and has dramatically changed the management of these patients. " 01/01/2007 - "In randomized studies of heterogeneous patients with hypoxemic acute respiratory failure, noninvasive positive pressure ventilation (NPPV) was associated with a significant reduction in endotracheal intubation. " 02/01/2012 - "Noninvasive positive pressure ventilation is beneficial for patients with acute respiratory failure. " 03/01/2010 - "Noninvasive positive pressure ventilation (NPPV) is another treatment modality that may be beneficial in patients with severe asthmatic attack who are at an increased risk of developing respiratory failure. " 05/01/2007 - "Noninvasive positive-pressure ventilation (NPPV) has been a major advance in the management of acute respiratory failure. "
5.	Extracorporeal Membrane Oxygenation 07/01/1996 - "We then present our experience from the past 11 years in the most invasive, yet successful, therapy for acute respiratory failure-extracorporeal membrane oxygenation (ECMO). " 12/23/2006 - "While extracorporeal membrane oxygenation is proven to result in improved outcome when compared to conventional ventilation in neonates with severe respiratory failure, there is currently no good evidence from randomised controlled trials to compare these managements for important clinical outcomes in adults, although evidence from case series is promising. " 12/01/1997 - "We conclude that AVCO2R in a simple arteriovenous shunt is a less complicated technique than extracorporeal membrane oxygenation and is capable of total CO2 removal that allows a significant reduction in the minute ventilation and peak airway pressure during severe respiratory failure." 01/01/2020 - "Pulmonary artery (PA) cannulation during peripheral venoarterial extracorporeal membrane oxygenation (ECMO) has been shown to be effective either for indirect left ventricular (LV) unloading or to allow right ventricular (RV) bypass with associated gas-exchange support in case of acute RV with respiratory failure. " 08/09/2018 - "Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an effective treatment for severe respiratory failure. "