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Katherine Rakoczy, MD, "Acute Respiratory Failure", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Acute respiratory failure (ARF) is an emergency that develops over minutes to hours, so that the situation can become life-threatening if appropriate interventions are not instituted. Infants and toddlers are at higher risk because they have proportionally large tongues and narrow subglottic regions, small and compliant airways, fewer alveoli, more compliant chest walls, more easily fatigued respiratory musculature, and an immature respiratory center. Additionally, children with metabolic, genetic, and developmental disorders have an increased incidence of poor airway control, chronic aspiration, severe muscle weakness, scoliosis, and restrictive lung disease.
Respiratory failure may be hypercarbic, hypoxemic, or a combination of both,...
