Respiratory High-Dependency Care Units for the burden of acute respiratory failure

Eur J Intern Med. 2012 Jun;23(4):302-8. doi: 10.1016/j.ejim.2011.11.002. Epub 2011 Nov 30.


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.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Bronchoscopy
  • Chronic Disease
  • Hospitals, Community
  • Humans
  • Patient Discharge
  • Positive-Pressure Respiration
  • Quality of Health Care
  • Respiratory Care Units* / organization & administration
  • Respiratory Insufficiency / therapy*
  • Tracheostomy
  • Ventilator Weaning