Which of the following is false about the "acute-on-chronic" form of respiratory failure?
a. It usually involves patients with hypox-emic respiratory failure.
b. It is most common in patients with chronic airway obstruction.
c. Bacterial or viral infections are common precipitating factors.
d. Mortality is associated with severity of acidosis.
ANS: A
Patients with chronic hypercapnic respiratory failure (chronic ventilatory failure) are at significant risk for this, as indicated by the fact that COPD is now the fourth leading cause of death in the United States. Acute-on-chronic respiratory failure can also be the presenting manifestation of neuromuscular disease in the setting of a concurrent pulmonary infection. Most common precipi-tating factors include bacterial or viral infections, congestive heart failure, pulmonary embolus, chest wall dysfunction, and medical noncompliance.
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