ABSTRACT
Scientific and technological advances in the care of critically ill and injured individuals of all ages have resulted in an unprecedented improvement in their survival and subsequent quality of life. Concomitant with these improvements have come rapid increases in the costs of health care (I), and the emergence of a relatively small but increasing number of persons living with severe disability. Most striking among these disabled persons are those with chronic respiratory failure requiring long-term mechanical ventilation. We. as well as others (2), consider chronic respiratory failure (CRF) to be a condition persisting for greater than I mo in which the impairment of ventilation requires that the patient receive mechanical ventilatory assistance, during part or all of the day, to provide adequate gas exchange for the support of vital functions.
