[Pneumologic emergency conditions in geriatrics. With special reference to risk factors]

Acute respiratory failure is a common life-threatening condition in old age. Structural alterations, progressive loss of lung functional reserves and weakening of pulmonary defense mechanisms are the main factors responsible. The aging lung itself contributes only little to the increased risk, but if combined with chronic lung disease, such as bronchitis, asthma, fibrosis, tuberculosis, pneumoconiosis, severe deterioration of lung function may occur. In many cases, respiratory failure results from an accumulation of the following factors: aging lung, chronic lung disease, cor pulmonale, acute complication. Today, chronic obstructive lung disease (COLD) is one of the most important conditions leading to ventilatory failure in the elderly. Carcinoma of the lung and other manifestations of malignant diseases may also be important. Treatment of the acute respiratory failure in the elderly must include three components: 1. treatment of the acute complication triggering the crisis, 2. treatment of the underlying chronic disease, 3. treatment of concomitant extrapulmonary diseases. After recovery, special attention must be directed towards preventing repeated respiratory failure.