Respiratory Compromise Institute (RCI) Issues New Podcast Series to Raise Awareness of Respiratory Compromise

VIENNA, Va.March 26, 2019 /PRNewswire/ — The Respiratory Compromise Institute (RCI) announced today the launch of the RCI podcast series, featuring industry-leading medical experts discussing respiratory compromise, a pulmonary condition generally characterized by the chronic or acute deterioration of respiratory function. Respiratory compromise in any form contributes to a higher risk of life-threatening respiratory failure. This provider education series is intended to promote a multidisciplinary dialogue among the medical community, especially in hospital settings, such as pulmonologists, anesthesiologists, hospitalists, respiratory therapists, critical care experts, emergency physicians, nurse anesthetists, chest physicians, medical academia, and other stakeholders who are responsible for patient safety, improving quality measures and promoting optimal clinical outcomes.

“Respiratory failure is the second leading avoidable patient safety issue.1 It is one of the top five conditions leading to increasing hospital costs2 and the third most rapidly increasing hospital inpatient cost in the United States.3,” states Phil Porte. Executive Director of the Respiratory Compromise Institute.  “General care floor patients with respiratory compromise are 29 times more likely to die due to these complications,2” he stated. This podcast series will provide important information on the current research and next steps to preventing respiratory compromise in hospitals across the nation and around the world.

The presentations in the available RCI podcast episodes were delivered at a recent gathering of respiratory therapists and allied medical providers at American Association of Respiratory Care (AARC18) in Las Vegas, Nevada on the following topics:

  • Introduction and Moderation presented by Dr. James Lamberti, MD, FCCP, Director, Respiratory Care Services at Inova Fairfax Hospital, Professor of Medicine, Virginia Commonwealth University School of Medicine, Inova Campus
  • History of Respiratory Compromise Institute (RCI) presented by Phillip Porte, RCI, Executive Director
  • Populations at Risk: Evidence from Medicare Data Mining presented by Dr. Lamberti, MD, FCCP, Director, Respiratory Care Services at Inova Fairfax Hospital, Professor of Medicine, Virginia Commonwealth UniversitySchool of Medicine, Inova Campus and Dr. Sidney Braman, MD, FCCP, Ichan School of Medicine at Mount Sinai
  • Future Research Considerations presented by Dr. Jeffery Vender, MD, FCCP, Evanston Hospital and Dr. Neil MacIntyre, MD, FCCP, Duke University Hospital

About Respiratory Compromise
Respiratory compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory compromise is the third most rapidly increasing hospital inpatient cost in the United States, with $7.8 billion spent on respiratory compromise in U.S. hospitals in 2007. Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute 
The Respiratory Compromise Institute brings together a broad-based coalition of medical organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

Learn more about the Respiratory Compromise Institute by visiting: http://www.respiratorycompromise.org/

References

Healthgrades website, “Quality Matters: Tackle the Top 3 Patient Safety Issues.” 
https://www.hospitals.healthgrades.com/index.cfm/customers/e-newsletters/april-2013/quality-matters-tackle-the-top-3-patient-safety-issues/. Accessed October 10, 2017.

Kelley SD, SA, Agarwal S, Parikh N, Erslon M, Morris P. Respiratory insufficiency, arrest and failure among medical patients on the general care floor. Crit Care Med. 2012; 40(12):764.

NAMDRC, National Association for Medical Direction of Respiratory Care. Reducing respiratory compromise and depression. PR Web. Available at http://www.prweb.com/pdfdownload/12615503.pdf.

Media Contact:  
Nancy Rose Senich
Cell/Text: (202)262-6996
Email:  nancy@rose4results.com

SOURCE Respiratory Compromise Institute (RCI)

Related Links
http://www.respiratorycompromise.org

Respiratory Compromise Institute (RCI) Issues Provider Education Presentations to Raise Awareness of Respiratory Compromise

VIENNA, Va.Jan. 22, 2019 /PRNewswire/ — The Respiratory Compromise Institute (RCI) announced today the launch of a series of video presentations of industry-leading medical experts discussing respiratory compromise, a pulmonary condition generally characterized by the chronic or acute deterioration of respiratory function. Respiratory compromise in any form contributes to a higher risk of life-threatening respiratory failure. This provider education series is intended to promote a multidisciplinary dialogue among the medical community, especially in hospital settings, such as pulmonologists, anesthesiologists, hospitalists, respiratory therapists, critical care experts, emergency physicians, nurse anesthetists, chest physicians, medical academia, and other stakeholders who are responsible for patient safety, improving quality measures and promoting optimal clinical outcomes.

“Respiratory failure is the second leading avoidable patient safety issue.1 It is one of the top five conditions leading to increasing hospital costs2 and the third most rapidly increasing hospital inpatient cost in the United States.3,” states Phil Porte, Executive Director of the Respiratory Compromise Institute.  “General care floor patients with respiratory compromise are 29 times more likely to die due to these complications,2” he stated. This video series will provide important information on the current research and next steps to preventing respiratory compromise in hospitals across the nation and around the world.

The presentations in the RCI video series were delivered at a recent gathering of respiratory therapists and allied medical providers at American Association of Respiratory Care (AARC18) in Las Vegas, Nevada on the following topics:

  • Overview of Respiratory Compromise Institute (RCI) Symposium (RCI-AARC18 Summary Video)
  • Introduction and Moderation presented by Dr. James Lamberti, MD, FCCP, Director, Respiratory Care Services at Inova Fairfax Hospital, Professor of Medicine, Virginia Commonwealth University School of Medicine, Inova Campus
  • History of Respiratory Compromise Institute (RCI) presented by Phillip Porte, RCI, Executive Director
  • Populations at Risk: Evidence from Medicare Data Mining presented by Dr. Lamberti, MD, FCCP, Director, Respiratory Care Services at Inova Fairfax Hospital, Professor of Medicine, Virginia Commonwealth UniversitySchool of Medicine, Inova Campus and Dr. Sidney Braman, MD, FCCP, Ichan School of Medicine at Mount Sinai
  • Future Research Considerations presented by Dr. Jeffery Vender, MD, FCCP, Evanston Hospital and Dr. Neil MacIntyre, MD, FCCP, Duke University Hospital

To access the series on RCI’s You Tube channel, please visit http://bit.ly/RCI-ProviderEd2018

About Respiratory Compromise
Respiratory compromise, which includes respiratory distress, insufficiency, failure, and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory compromise is the third most rapidly increasing hospital inpatient cost in the United States, with $7.8 billion spent on respiratory compromise in U.S. hospitals in 2007. Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute 
The Respiratory Compromise Institute brings together a broad-based coalition of medical organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

Learn more about the Respiratory Compromise Institute by visiting: http://www.respiratorycompromise.org/

References

Healthgrades website, “Quality Matters: Tackle the Top 3 Patient Safety Issues.” 
https://www.hospitals.healthgrades.com/index.cfm/customers/e-newsletters/april-2013/quality-matters-tackle-the-top-3-patient-safety-issues/. Accessed October 10, 2017.

Kelley SD, SA, Agarwal S, Parikh N, Erslon M, Morris P. Respiratory insufficiency, arrest and failure among medical patients on the general care floor. Crit Care Med. 2012; 40(12):764.

NAMDRC, National Association for Medical Direction of Respiratory Care. Reducing respiratory compromise and depression. PR Web. Available at http://www.prweb.com/pdfdownload/12615503.pdf.

RCI Launches Study of Unplanned Intubations to Better Understand Respiratory Compromise

Duke Study Press Release 09/19/18 — Study Aims to Assess Demographic, Clinical Characteristics and Care Practices That Increase Patients’ Risk for Potentially Deadly Condition  

DURHAM, N.C. — The Respiratory Compromise Institute today announced the initiation of a clinical study aimed at better understanding the prevalence, risk factors and pathways for unplanned airway intubations as a measure of respiratory compromise. Respiratory compromise is a deterioration of respiratory function that poses a high risk of life-threatening respiratory failure, the second leading avoidable patient safety issue.1 General care floor patients with respiratory compromise are 29 times more likely to die.2

Led by Neil MacIntyre, MD, FCCP, Professor of Medicine (Pulmonary, Allergy and Critical Care Medicine) at Duke University School of Medicine, and supported by the Respiratory Compromise Institute (RCI), the study will draw on the electronic health records of patient encounters at DUHS’ three hospitals: Duke University Hospital (DUH), Duke Regional Hospital (DRH) and Duke Raleigh Hospital (DRAH). 

The study researchers hope to assess demographic, clinical and care practice characteristics that impact the risk profile of patients 18 years or older with unplanned intubations 24 hours or more after admission or surgery on general medical and surgical floors. The source population will include patients at DUH, DRH and DRAH admitted from January 1, 2014 to December 31, 2017. DUH is a large, 957-acute care bed academic facility, providing tertiary referral care for North Carolina; DRH is a 369-bed community-based facility attending to underserved populations in Durham County, North Carolina; and DRAH is a 186-bed facility serving Raleigh, North Carolina.  

“Our study uses unplanned intubations as an end result of progressive respiratory compromise, which may be difficult to detect early and have a high incidence in minimally monitored care settings, such as medical and surgical floors,” said Dr. MacIntyre. “If we can identify which patient characteristics and aspects of clinical practice present the greatest risk, then healthcare providers will be better positioned to prevent or mitigate respiratory compromise. Furthermore, we believe that, by creating a data and analytics framework that can be adapted to other institutions, our study will serve as a model for future research.”

Demographic data that investigators will be examining to assess patient risk for respiratory compromise include: age, race/ethnicity, sex, smoking and alcohol status. Researchers will also be looking at vital signs, laboratory data and clinical picture along with pre-existing medical conditions, such as diabetes, liver disease, cancer and other factors that can increase patients’ risk. The impact of commonly prescribed medications, including benzodiazepines and sleep aids, will also be assessed. 

“Electronic health records enable us to amass large quantities of data on patients, which can and should be utilized to understand patient risk for a variety of health conditions that arise during in-hospital patient care,” said Phillip Porte, Executive Director of RCI. “Innovative research like the kind being conducted by Dr. MacIntyre will help us continue to deepen our understanding of and hopefully better recognize and prevent respiratory compromise, which has been the aim of the Respiratory Compromise Institute since its founding.”  

The study’s expected completion date is end of 2018. Dr. MacIntyre’s co-investigators include: Armando Bedoya, MD, MMCi, Nrupen Bhavsar, PhD, MPH, and Benjamin Goldstein, PhD, MPH.  

About Respiratory Compromise
Respiratory compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory failure is the fourth most common patient safety event.3 In patient respiratory compromise costs are expected to surpass $37 billion by 2019.4 Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute
The Respiratory Compromise Institute brings together a broad-based coalition of organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

References

  1. Healthgrades website, “Quality Matters: Tackle the Top 3 Patient Safety Issues.” 
  2. Kelley SD, SA, Agarwal S, Parikh N, Erslon M, Morris P. Respiratory insufficiency, arrest and failure among medical patients on the general care floor. Crit Care Med. 2012; 40(12):764.
  3. 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy Content Last Reviewed May 2016. Rockville, MD: Agency for Healthcare Research and Quality; April 2016.
  4. Agarwal SJ, Erslon MG, Bloom JD. Projected incidence and cost of respiratory failure, insufficiency and arrest in Medicare population, 2019. Abstract presented at Academy Health Congress, June 2011.

Respiratory Compromise Institute Appoints Brent Dunworth to Clinical Advisory Committee

VIENNA, Va., Jan. 31, 2018 /PRNewswire/ — The Respiratory Compromise Institute (RCI) today announced the appointment of Brent Dunworth, DNP, MBA, APRN, CRNA, to its Clinical Advisory Committee. Dr. Dunworth is a member of the American Association of Nurse Anesthetists (AANA), the professional association for more than 52,000 Certified Registered Nurse Anesthetists, and serves as Director of Advanced Practice and Division Chief of Nurse Anesthesia in the Department of Anesthesiology at Vanderbilt University Medical Center (VUMC) in Nashville, Tennessee. He will join a group of thirteen distinguished clinicians who make up the committee, which is dedicated to addressing respiratory compromise across the care continuum via public education, research and advocacy.

Respiratory compromise is a deterioration of respiratory function that poses a high risk of life-threatening respiratory failure. Respiratory failure is the second leading avoidable patient safety issue.1 It is one of the top five conditions leading to increasing hospital costs2 and the third most rapidly increasing hospital inpatient cost in the United States.3 General care floor patients with respiratory compromise are 29 times more likely to die.2

Dr. Dunworth is an educator at the Vanderbilt University School of Nursing and lectures nationally on a variety of nurse anesthesia topics. He has received numerous awards, including: the Agatha Hodgins Award, presented to outstanding nurse anesthesia students; the Pennsylvania Association of Nurse Anesthetists’ Didactic Instructor of the Year Award; and the University of Pittsburgh School of Nursing’s Outstanding Young Alumnus Award. He has given more than 40 presentations on anesthesia-related subjects, such as difficult airway management, anesthesia ventilation, patient safety advocacy in anesthesiology, and problems associated with sleep-disordered breathing. His peer-reviewed publications and abstracts have appeared in AACN Clinical Issues: Advanced Practice in Acute and Critical Care, American Journal of Nursing, AANA Journal and Anesthesia & Analgesia.

“As the Respiratory Compromise Institute continues to grow, we are pleased to have someone on our clinical advisory committee of Dr. Dunworth’s caliber,” said, Phillip Porte, Executive Director of RCI. “We are confident that his nearly 20 years of clinical experience and increasingly responsible leadership at renowned U.S. healthcare centers will enhance our understanding of the impact of anesthesia on respiratory compromise, deepen our advisory talent bench and enrich and expand our research capabilities.”

At VUMC, Dr. Dunworth provides administrative leadership to advanced practice perioperative professionals, including certified registered nurse anesthetists (CRNAs) and certified registered nurse practitioners (CRNPs). His oversight responsibilities include preoperative evaluations, procedural assessments and postoperative recovery monitoring in order to provide safe and efficient patient care delivery. He is responsible for 160 CRNAs, 25 CRNPs and 30 anesthesia technologists. Prior to VUMC, he was Senior Director for Nurse Anesthesia at the University of Pittsburgh Medical Center.

“I am excited to join the Respiratory Compromise Institute’s clinical advisory committee, where I hope my expertise in nurse anesthesia will add to the committee’s already impressive clinical thought leadership,” said Dr. Dunworth. “Practitioners at every level should be well versed in how to recognize and respond to respiratory compromise, which, if identified early, may lower healthcare costs and improve patient outcomes.”

About Respiratory Compromise
Respiratory compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory compromise is the third most rapidly increasing hospital inpatient cost in the United States, with $7.8 billion spent on respiratory compromise in U.S. hospitals in 2007. Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute
The Respiratory Compromise Institute brings together a broad-based coalition of organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

References

1 Healthgrades website, “Quality Matters: Tackle the Top 3 Patient Safety Issues.”

2 Kelley SD, SA, Agarwal S, Parikh N, Erslon M, Morris P. Respiratory insufficiency, arrest and failure among medical patients on the general care floor. Crit Care Med. 2012; 40(12):764.

3 NAMDRC, National Association for Medical Direction of Respiratory Care. Reducing respiratory compromise and depression. PR Web. Available at http://www.prweb.com/pdfdownload/12615503.pdf.

https://www.prnewswire.com/news-releases/respiratory-compromise-institute-appoints-brent-dunworth-to-clinical-advisory-committee-300590819.html

Respiratory Compromise Institute Highlights Dangers and Growing Incidence of Respiratory Compromise – a Potentially Deadly Condition – at CHEST 2017

VIENNA, VA – October 31, 2017 – The Respiratory Compromise Institute (RCI) was selected to present an update on respiratory compromise — a potentially deadly condition — at CHEST 2017, the annual meeting of the American College of Chest Physicians, taking place in Toronto.

Respiratory compromise is a deterioration of respiratory function that poses a high risk of life-threatening respiratory failure. Respiratory failure is the second leading avoidable patient safety issue.1 It is one of the top five conditions leading to increasing hospital costs2 and the third most rapidly increasing hospital inpatient cost in the United States.3 General care floor patients with respiratory compromise are 29 times more likely to die.2

The plenary workshop presentation, “The Respiratory Compromise Institute and Its Current and Future Research Endeavors,” introduced the RCI to clinicians attending the CHEST meeting. The session also highlighted the latest research on the growing incidence of respiratory compromise through data mined from Medicare claims and delineated future areas for research to better understand how to reduce the incidence of respiratory compromise in both medical and surgical patient populations.

“Our institute is a one-of-a-kind medical society alliance, dedicated to better understanding, raising awareness about and developing strategies to improve the identification and prevention of respiratory compromise, an under-recognized condition with potentially fatal consequences,” said James Lamberti, MD, FCCP, Professor of Medicine, Virginia Commonwealth University School of Medicine, one of the workshop presenters. “My colleagues at the Respiratory Compromise Institute are committed to enhancing the breadth and depth of knowledge about this condition, as well as developing diagnostic and mitigation approaches that drive down the incidence of respiratory compromise and improve health and economic outcomes.”

Additional workshop presenters included: Gerry Criner, MD, FACP, FACCP, Chair and Professor, Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University; Phillip Porte, Executive Director of RCI; Sidney Braman, MD, FCCP, Ichan School of Medicine at Mount Sinai; Neil MacIntyre, MD, FCCP, Duke University Hospital; and Jeffrey Vender, MD, FCCP, Evanston Hospital.

In May at ATS 2017, the annual meeting of the American Thoracic Society, RCI had presented two studies evaluating mortality associated with respiratory compromise in hospitalized Medicare patients. The studies were the first retrospective analyses of mortality associated with respiratory compromise (as measured by respiratory failure) based on Medicare administrative claims data. The findings identified respiratory compromise as a leading cause of mortality in hospitalized Medicare patients.

See an animation about respiratory compromise by visiting: https://www.youtube.com/watch?v=jHZuuEAmDSE

About Respiratory Compromise

Respiratory compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory compromise is the third most rapidly increasing hospital inpatient cost in the United States, with $7.8 billion spent on respiratory compromise in U.S. hospitals in 2007. Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute

The Respiratory Compromise Institute brings together a broad-based coalition of organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

Medtronic Initiates PRODIGY

Medtronic Initiates PRODIGY – a Global Study to Identify Those at High Risk for Opioid Induced Respiratory Depression, a Preventable Form of Respiratory Compromise

Medtronic announced last week the initiation of the PRODIGY study, a prospective, multi-center, post-market, global study to Identify individuals at high risk for opioid induced respiratory depression (OIRD), a form of respiratory compromise.

PRODIGY is an important study as it is the first to assess the clinical and economic benefits of using pulse oximetry and capnography in patients receiving opioid medication on hospital general care floors. Findings from the study will potentially help clinicians determine strategies for earlier detection and prevention of OIRD.

https://globenewswire.com/news-release/2017/05/31/1003946/0/en/Medtronic-Initiates-PRODIGY-a-Global-Study-to-Identify-Those-at-High-Risk-for-Opioid-Induced-Respiratory-Depression-a-Preventable-Form-of-Respiratory-Compromise.html

Respiratory Compromise Institute Presents Data Underscoring Respiratory Compromise as a Leading Cause of Mortality in Hospitalized Medicare Patients

Two Studies Presented at ATS 2017 Underscore Need for Better Monitoring and Earlier Treatment of Elderly Patients to Reduce Respiratory Compromise

Vienna, VA – May 21, 2017 – The Respiratory Compromise Institute (RCI) today announced results of two studies evaluating mortality associated with respiratory compromise in hospitalized Medicare patients. The abstracts were presented at ATS 2017, the annual meeting of the American Thoracic Society, which is taking place in Washington, D.C., May 19-24.

Respiratory compromise is a deterioration of respiratory function that poses a high risk of life-threatening respiratory failure. Respiratory failure is the second leading avoidable patient safety issue.1 It is one of the top five conditions leading to increasing hospital costs2 and the third most rapidly increasing hospital inpatient cost in the United States.3 General care floor patients with respiratory compromise are 29 times more likely to die. The ECRI Institute recently identified opioid administration and monitoring in acute care as a top ten patient safety concern.

The studies are the first retrospective analyses of mortality associated with respiratory failure based on Medicare administrative claims data for inpatient admissions to short-term acute care hospitals. The study was conducted for the time period between January 1, 2012 and December 31, 2014. Based on a review of the Medicare database of hospital admissions, an annual estimate of at least 111,020 Medicare beneficiaries suffer from respiratory compromise.

The first study (Abstract #A1895) evaluated medical records for patients who developed respiratory failure after hospitalization for medical (n =16,653) or surgical (n =13,895) inpatient stays. The average age for the medical and surgical groups was 73.2 and 72.4 years of age, respectively.

In-hospital mortality was greater for medical compared with surgical patients (32.7% vs. 25.1%, p < 0.0001). Mortality during the 30 days post-discharge was also greater for medical compared with surgical patients (15.3% vs. 9.8%, p < 0.0001). In both medical and surgical groups, hospital mortality was considerably worse when acute kidney failure occurred during the hospitalization (p < 0.0001). While both groups had a high rate of intubation, medical patients had more non-invasive mechanical ventilation compared with surgical patients (33% vs. 14%, p < 0.001). The majority of patients in both groups showed evidence of a prior hospitalization within the year previous to the index admission used in this analysis. Medical patients were more likely to have been in a skilled nursing facility (26% vs. 16%, p < 0.001).

“While these data verify that respiratory compromise is a significant safety issue in the hospital setting, particularly among this elderly population, we know that it can be identified in most cases and by doing so, acute respiratory failure may be prevented,” said Sidney Braman, MD, Professor in the Pulmonary, Critical Care and Sleep Medicine Division of the Icahn School of Medicine at Mount Sinai – National Jewish Health Respiratory Institute and lead author of the study. “The results support the need for improved monitoring and intervention strategies to reduce the risk of respiratory compromise and improve outcomes.”

The other study (Abstract #A1893) compared Medicare patients who had hospital-acquired respiratory compromise (HARC) (n=16,653, average age 73.2 years) with patients who had respiratory failure diagnosed at the time of hospital admission (n = 18,503, average age = 70.8 years). In-hospital mortality was 32.7% in patients with HARC versus 27.8% in those patients with respiratory failure diagnosed at time of hospital admission (p < 0.0001). Mortality at 30 days post hospital discharge was also significantly different (HARC: 15.3% and respiratory failure at time of hospital admission: 12.9%, p = 0.0001). Patients with HARC had high rates of concomitant diseases (chronic heart failure (45%), hypertension (38%), atrial fibrillation (35%), acute kidney failure (36%), pneumonia (31%) and septicemia (26%).
“This analysis shows that Medicare patients who are recognized as having respiratory failure after hospitalization have significantly higher mortality than patients diagnosed as having respiratory failure at time of hospital admission,” said James P. Lamberti, MD, Professor of Medicine at Virginia Commonwealth University Inova Campus and Medical Director of Respiratory Care Services at Inova Fairfax Hospital. “The fact that 48% of patients who develop HARC either die in the hospital or within 30 days of hospital discharge demonstrates the urgent need for further study of HARC. Since this study utilized Medicare administrative claims data, a prospective observation study is required to understand the time course and progression of respiratory compromise after hospital admission. Better clinical data will hopefully allow development of strategies for early identification and intervention in the continuum of respiratory compromise to respiratory failure within the hospital. Further study will also identify the role of palliative care in this group of patients with a very high risk of death.”

Phillip Porte, Executive Director of RCI, commented: “Collectively, the study results suggest the urgent need for further study of hospital acquired respiratory compromise, with a focus on early identification and preventative strategies to reduce respiratory compromise. While data on respiratory compromise are limited, these two studies help establish a foundation of the incidence among elderly patients in the hospital setting and provide a compelling call to action to improve our understanding to prevent and manage respiratory compromise to mitigate progression to more debilitating forms of respiratory dysfunction.”

About Respiratory Compromise

Respiratory compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory compromise is the third most rapidly increasing hospital inpatient cost in the United States, with $7.8 billion spent on respiratory compromise in U.S. hospitals in 2007. Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute

The Respiratory Compromise Institute brings together a broad-based coalition of organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

Media Contact
Erich Sandoval
Lazar Partners Ltd.
Tel: +1 917-497-2867
Email: esandoval@lazarpartners.com

Respiratory Care Publication Identifies Respiratory Compromise as a Critical Safety Issue for Managing Hospitalized Patients to Reduce Respiratory Failure and Death

Respiratory Compromise Institute Monograph Recommends Better Detection and Earlier Intervention of Respiratory Compromise to Reduce Morbidity and Mortality in At-Risk Patients

Vienna, VA – May 2, 2017 – The Respiratory Compromise Institute (RCI) today announced that a monograph published in the April issue of Respiratory Care provides a foundation to identify patients at risk for respiratory compromise. The monograph also recommends that clinicians implement monitoring and intervention strategies to reduce these patients’ risks for respiratory failure and death. Currently, guidelines from numerous medical societies recommend the use of monitoring for patients at risk of respiratory compromise to provide early detection and intervention.

Respiratory compromise is a potentially life threatening state of unstable respiratory health that encompasses respiratory failure and arrest. Respiratory failure requiring emergency mechanical ventilation occurs in more than 44,000 patients each year in the United States, and the ECRI Institute just recently identified opioid administration and monitoring in acute care as a top ten patient safety concern.
The monograph is the output from a sentinel workshop of expert representatives from seven national physician, nurse and respiratory therapist medical societies who met to address the issue of identifying, detecting and treating respiratory compromise from a clinical practice perspective. The workshop sought to lay the groundwork for future research and analysis that could help guide the medical community on how to identify respiratory compromise early and intervene promptly to reduce the incidence of respiratory compromise and thereby prevent respiratory failure.

“Hospitalized patients have an unacceptably high incidence of respiratory failure and death, and intervening at the earliest stages of respiratory compromise will be essential to reduce patients’ risks and improve outcomes,” said Timothy A. Morris, MD FCCP, Professor of Clinical Medicine, Clinical Service Chief of the Pulmonary, Critical Care and Sleep Division at UC San Diego Medical Center in Hillcrest, President of the Respiratory Compromise Institute and lead author of the monograph. “Classifying at-risk patients based on their physiologic profiles may enable the development of risk-specific monitoring strategies and early interventions that can prevent further respiratory decline.”

The monograph identified six distinct patient sub-types based on physiologic parameters: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema and right ventricular failure. The monograph also included guidelines for identifying patients with each type of respiratory compromise, early signs of respiratory compromise, and parameters for monitoring patients’ pulmonary and other vital functions.
“A key challenge in preventing and mitigating respiratory compromise in hospitalized patients is that it affects a diverse population of patients and may have different manifestations based on patients’ pre-admission respiratory status and co-morbid conditions,” said Phillip Porte, Executive Director of RCI. “Currently, today’s paradigms focus on rescuing patients in respiratory failure rather than preventing progression of respiratory compromise, and we believe our monograph provides a framework for the medical community to explore that can reduce the incidence of respiratory compromise.”
Monitoring strategies identified for several patient sub-types include simple and non-invasive methods such as pulse oximetry, EKG, capnography, and monitoring of heart and breathing rates. Identifying patient sub-groups in which these and other monitoring are most beneficial is an important first step toward improving patient outcomes in a cost-effective manner.

About Respiratory Compromise

Respiratory compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, respiratory compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.

According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, respiratory compromise is the third most rapidly increasing hospital inpatient cost in the U.S., with $7.8 billion spent on respiratory compromise in U.S. hospitals in 2007. Respiratory compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. RCI defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).

About Respiratory Compromise Institute

The Respiratory Compromise Institute brings together a broad-based coalition of organizations, companies, and individuals dedicated to reducing—and eventually eliminating—preventable adverse events and deaths due to respiratory compromise.

Media Contact
Erich Sandoval, Lazar Partners Ltd.
Tel: +1 917-497-2867
Email: esandoval@lazarpartners.com