title: Respiratory High-Dependency Care Units for the burden of acute respiratory failure.
abstract: The burden of acute respiratory failure (ARF) has become one of the greatest epidemiological challenges for the modern health systems. Consistently, the imbalance between the increasing prevalence of acutely de-compensated respiratory diseases and the shortage of high-daily cost ICU beds has stimulated new health cost-effective solutions. Respiratory High-Dependency Care Units (RHDCU) provide a specialised environment for patients who require an "intermediate" level of care between the ICU and the ward, where non-invasive monitoring and assisted ventilation techniques are preferentially applied. Since they are dedicated to the management of "mono-organ" decompensations, treatment of ARF patients in RHDCU avoids the dangerous "under-assistance" in the ward and unnecessary "over-assistance" in ICU. RHDCUs provide a specialised quality of care for ARF with health resources optimisation and their spread throughout health systems has been driven by their high-level of expertise in non-invasive ventilation (NIV), weaning from invasive ventilation, tracheostomy care, and discharging planning for ventilator-dependent patients.
authors.affiliation: UO Pneumologia, UTIR e Interventistica, Campo di Marte Hospital, Lucca, Italy. raffaele_scala@hotmail.com
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scala
mesh_terms: D000208:Acute Disease; D001999:Bronchoscopy; D002908:Chronic Disease; D006764:Hospitals, Community; D006801:Humans; D010351:Patient Discharge; D011175:Positive-Pressure Respiration; D011787:Quality of Health Care; D012124:Respiratory Care Units / Q000458:organization & administration; D012131:Respiratory Insufficiency / Q000628:therapy*; D014139:Tracheostomy; D015300:Ventilator Weaning