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Published on: April 7, 2021
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[Acute respiratory failure in the elderly patients]
Vincent Bonny1, Mathilde Ladoire1, Paul Gabarre1
1Hôpital Saint-Antoine, médecine intensive-réanimation, AP-HP, Paris, France.
La Revue Du Praticien
|December 13, 2022
Summary
Elderly patients face higher risks of acute respiratory failure (ARF). Prognosis depends on frailty and comorbidities, not just age, guiding intensive care decisions.
Area of Science:
- Geriatrics
- Critical Care Medicine
- Pulmonology
Context:
- Acute respiratory failure (ARF) in older adults presents unique diagnostic, therapeutic, and prognostic challenges.
- Elderly individuals have an elevated susceptibility to ARF following various health insults.
- Assessing prognosis is crucial for older patients requiring intensive care unit (ICU) admission for ARF.
Purpose:
- To highlight the specific characteristics of ARF in elderly patients.
- To emphasize the importance of comprehensive prognostic assessment beyond chronological age.
- To advocate for a multi-professional approach in managing ARF in the elderly.
Summary:
- Mortality in elderly ARF patients is influenced by comorbidities, functional status, ARF severity, and frailty, in addition to age.
- Tools exist to reliably assess frailty, aiding in clinical decision-making.
- Physiological age is a more relevant factor than chronological age for determining the intensity of care.
Impact:
- Promotes individualized treatment strategies for elderly ARF patients.
- Encourages the integration of geriatric-specific assessments into critical care protocols.
- Stresses the need for early, multi-professional rehabilitation, including physiotherapy, for improved outcomes.
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