[Evaluation of a respiratory care unit on a 45-bed hospital ward]

With a limited number of beds for patients undergoing medical and surgical treatment for respiratory diseases, we set aside 6 of 45 beds on one floor to be used as a respiratory care unit. During the past 5 years, 1820 patients (1225 medical and 595 surgical) were admitted to the respiratory care unit; they were treated for an average of 5.02 days. Of the patients being treated medically, 451 received mechanical ventilatory support. The majority of those patients had acute exacerbations of chronic respiratory failure due to emphysema or to sequelae of pulmonary tuberculosis. Acute respiratory distress associated with asthma or with pneumonia were also relatively common, as was the adult respiratory distress syndrome. A total of 119 patients on home oxygen therapy are being seen as out-patients, and the respiratory care unit was found to be quite useful whenever they needed intensive management. Only 148 (8.1%) of the patients admitted to the respiratory care unit died before discharge, and the ratio of cost to performance was good. The respiratory care unit was most effective in allowing for continuity of care from the onset of respiratory distress, and including exacerbations, surgical interventions, postoperative management, and out-patient care.