Respiratory Compromise Definition

Respiratory compromise is a state in which there is a high likelihood of decompensation into respiratory insufficiency and failure, respiratory arrest or death, but in which specific interventions (continuous monitoring and therapies) might prevent or mitigate decompensation.1

Discover below the different types and which respiratory and monitoring solutions from Medtronic can help with the early identification of respiratory compromise. 

What is respiratory insufficiency?

Respiratory Insufficiency Definition 

Respiratory failure occurs when one of the gas-exchange functions—oxygenation or CO2 elimination—fails.2 In clinical studies evaluating the incidence or impact of respiratory insufficiency, the condition may be defined in a variety of ways, such as: a decrease in respiratory rate, a reduction in oxygen saturation of hemoglobin, or as a change in arterial blood gasses.3,4,5,6,7 

Definitions and corresponding terms used to represent respiratory insufficiency in literature vary significantly.

Medtronic Respiratory & Monitoring Solutions EMEA

What is respiratory insufficiency

What is respiratory failure?

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What is respiratory arrest?

  • *On an average, 2.5 reasons for respiratory failure were reported per patient.

  • 1. Respiratory Compromise Institute. http://www.respiratorycompromise.org/. 2017.

  • 2. Stedman, T. L. (2008).Stedman's Medical Dictionary for the Health Professions & Nursing. Philadelphia, PA: Lippincott Williams & Wilkins.

  • 3. Cacho, G., Perez-Calle, J. L., Barbado, A., Lledo, J. L., Ojea, R., & Fernandez-Rodriguez, C. M. Capnography is superior to pulse oximetry for the detection of respiratory depression during colonoscopy. Rev Esp Enferm Dig. 2010;102(2):86-89.

  • 4. Hanna, M. H., Elliott, K. M., & Fung, M. Randomized, double-blind study of the analgesic efficacy of morphine-6- glucuronide versus morphine sulfate for postoperative pain in major surgery. Anesthesiology. 2005;102(4):815-821.

  • 5. Overdyk, F. J., Carter, R., Maddox, R. R., Callura, J., Herrin, A. E., & Henriquez, C. Continuous oximetry/capnometry monitoring reveals frequent desaturation and bradypnea during patient-controlled analgesia.Anesth Analg. 2007;105(2):412-418.

  • 6. Sun, Z., Sessler, D. I., Dalton, J. E., et al. Postoperative Hypoxemia Is Common and Persistent: A Prospective Blinded Observational Study. Anesth Analg. 2015;121(3):709-715.

  • 7. Weingarten, T. N., Herasevich, V., McGlinch, M. C., et al. Predictors of Delayed Postoperative Respiratory Depression Assessed from Naloxone Administration. Anesth Analg. 2015;121(2):422-429.

  • 8. Grosse-Sundrup, M., Henneman, J. P., Sandberg, W. S., et al. Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: prospective propensity score matched cohort study. BMJ. 2012;345:e6329.

  • 9. Vaessen, H., Bruens, E., & Knape, J. Clinical analysis of moderate-to-deep-sedation by nonmedical sedation practitioners in 597 patients undergoing gastrointestinal endoscopy: a retrospective study. Endosc Int Open. 2016;4(5):E564-571.

  • 10. Weingarten, T. N., Jacob, A. K., Njathi, C. W., Wilson, G. A., & Sprung, J. Multimodal Analgesic Protocol and Postanesthesia Respiratory Depression During Phase I Recovery After Total Joint Arthroplasty. Reg Anesth Pain Med. 2015;40(4):330-336.

  • 11. Canet, J., Sabate, S., Mazo, V., et al. Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: A prospective, observational study. Eur J Anaesthesiol. 2015;32(7):458-470.

  • 12. Ramachandran, S. K., Nafiu, O. O., Ghaferi, A., Tremper, K. K., Shanks, A., & Kheterpal, S. Independent predictors and outcomes of unanticipated early postoperative tracheal intubation after nonemergent, noncardiac surgery. Anesthesiology. 2011;115(1):44-53.

  • 13. Fischer, J. P., Shang, E. K., Butler, C. E., et al. Validated model for predicting postoperative respiratory failure: analysis of 1706 abdominal wall reconstructions. Plast Reconstr Surg. 2013;132(5):826e-835e.

  • 14. Alvarez, M. P., Samayoa-Mendez, A. X., Naglak, M. C., Yuschak, J. V., & Murayama, K. M. Risk Factors for Postoperative Unplanned Intubation: Analysis of a National Database.Am Surg. 2015;81(8):820-825.

  • 15. Hua, M., Brady, J. E., & Li, G. A scoring system to predict unplanned intubation in patients having undergone major surgical procedures.Anesth Analg. 2012;115(1):88-94.

  • 16. Milgrom, D. P., Njoku, V. C., Fecher, A. M., Kilbane, E. M., & Pitt, H. A. Unplanned intubation: when and why does this deadly complication occur?Surgery. 2013;154(2):376-383.

  • 17. Husband, A., Mercer, I., Detering, K. M., Eastwood, G. M., & Jones, D. A. The epidemiology of respiratory arrests in a teaching hospital. Resuscitation. 2013.

  • 18. Maddox, R. R., Oglesby, H., Williams, C. K., Fields, M., & Danello, S. (2008). Continuous Respiratory Monitoring and a "Smart" Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period.

  • 19. Overdyk, F. J., Carter, R., Maddox, R. R., Callura, J., Herrin, A. E., & Henriquez, C. Continuous oximetry/capnometry monitoring reveals frequent desaturation and bradypnea during patient-controlled analgesia. Anesth Analg. 2007;105(2):412-418.