Epidemiology

Studies of acute respiratory failure in intensive care units in Europe report an incidence of 77.6 in 100,000 per year in Sweden, Denmark, and Iceland, 88.6 in 100,000 per year in Germany, and 149.5 in 100,000 per year in Finland; mortality rates were around 40%.[7][8][9] More recent incidence data are lacking from the literature.

In the US, the number of hospitalisations owing to acute respiratory failure increased from 1,007,549 in 2001 to 1,917,910 in 2009. During the same period, a decrease in mortality from 27.6% to 20.6% was observed. Rates of mechanical ventilation (non-invasive or invasive) remained fairly stable over this 9-year period; however, the use of non-invasive ventilation did increase from 4% to 10%.[10] Mortality associated with acute respiratory failure is often related to a person’s overall health and the potential development of systemic organ dysfunction that can occur with acute illness.

Acute respiratory failure is often associated with pulmonary infections, the most common infection being pneumonia. Adults over 65 years and people with pre-existing health problems are particularly at-risk for pneumonia.[11] The US Centers for Disease Control and Prevention reported that the US death rate from lower respiratory diseases in 2019 was 47.8 people in 100,000, and 15.2 people in 100,000 from influenza and pneumonia, with higher rates for older population groups.​[12]

The coronavirus (COVID-19) pandemic introduced new challenges for recognition, treatment, and complications of acute respiratory failure with a larger population of patients with acute respiratory distress syndrome (ARDS).​[13] One study suggested a nearly five-fold increase in deaths related to ARDS in the US during 2020 and a diagnosis of COVID-19 present in over 80% of all ARDS-related deaths that year.[14]​​

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