Respiratory failure historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  M. Khurram Afzal, MD [2]

## Overview

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The diagnostic and treatment strategies for respiratory failure and its associated conditions have come a long way. Since the discovery of the stethoscope by René Laennec in 1816, to the work of Fenn and his team in 1946 on pulmonary gas exchange, the use of cuffed endotracheal tubes by Ibsen in 1954 to administer positive pressure ventilation to patients in respiratory failure who were admitted to the intensive care units, that became common in the United States in 1960.

## Historical Perspective

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### Discovery

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* In 1816 René Laennec invented the stethoscope.[1]
* In 1821 René Laennec first described the gross pathology of idiopathic anasarca of the lungs; pulmonary edema without heart failure.
* In 1896 W.C. Roentgen had described X-rays.[2]
* The limitation was that early chest X-rays required an exposure time of more than 20 minutes, hence they were not used until 1920.
* In 1946 Fenn and his team published their work on pulmonary gas exchange, relating PO2, PCO2, respiratory exchange ratio, arterial oxygen saturation, alveolar ventilation and altitude.[3]
* In 1954 Clark first developed an electrode which was used for the measurement of PO2, showing the oxygen level in the blood.[4]
* In 1960 the use of intensive care units became common in the United States.[5]
* In 1967 Ashbaugh and his team identified acute respiratory distress syndrome.[6]

## Landmark Events in the Development of Treatment Strategies

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* In 1936 Cortisone was first extracted.[7]
* In 1950 Cortisone was used to treat asthma.
* In 1954 Ibsen used cuffed endotracheal tubes to administer positive pressure ventilation to patients in respiratory failure admitted to the ICU.[8]
* In 1960 Moss and his coworkers discovered the benefits of using chest compressions to achieve artificial circulation.[9]

## References

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1. ↑ Laennec, Rene (1829). A treatise on the diseases of the chest, tr. by J. Forbes. London: Thomas & George Underwood.
2. ↑ Posner E (May 1971). "The early years of chest radiology in Britain". Thorax. 26 (3): 233–9. PMC 1019077. PMID 4934579.
3. ↑ FENN WO, RAHN H, OTIS AB (August 1946). "A theoretical study of the composition of the alveolar air at altitude". Am. J. Physiol. 146: 637–53. doi:10.1152/ajplegacy.1946.146.5.637. PMID 20996488.
4. ↑ CLARK LC, KAPLAN S, MATTHEWS EC, EDWARDS FK, HELMSWORTH JA (October 1958). "Monitor and control of blood oxygen tension and pH during total body perfusion". J Thorac Surg. 36 (4): 488–96. PMID 13588706.
5. ↑ Calvin JE, Habet K, Parrillo JE (April 1997). "Critical care in the United States. Who are we and how did we get here?". Crit Care Clin. 13 (2): 363–76. PMID 9107513.
6. ↑ Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (March 2005). "Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. The Lancet, Saturday 12 August 1967". Crit Care Resusc. 7 (1): 60–1. PMID 16548822.
7. ↑ Lundberg IE, Grundtman C, Larsson E, Klareskog L (February 2004). "Corticosteroids--from an idea to clinical use". Best Pract Res Clin Rheumatol. 18 (1): 7–19. doi:10.1016/j.berh.2003.10.003. PMID 15123034.
8. ↑ IBSEN B (January 1954). "The anaesthetist's viewpoint on the treatment of respiratory complications in poliomyelitis during the epidemic in Copenhagen, 1952". Proc. R. Soc. Med. 47 (1): 72–4. PMC 1918820. PMID 13134176.
9. ↑ KOUWENHOVEN WB, JUDE JR, KNICKERBOCKER GG (July 1960). "Closed-chest cardiac massage". JAMA. 173: 1064–7. PMID 14411374.

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