A Case of Chronic Respiratory Failure1

A case report is presented of a woman who survived 18 years after her first admission with respiratory failure. Despite persistent respiratory failure, autopsy revealed only slight emphysema. During the 18 years between the patient's first admission and her death her respiratory function was assessed on many occasions. The forced expiratory volume in one second and mixed venous carbon dioxide tension remained remarkably stable between exacerbations of her illness despite repeated episodes of purulent bronchitis. She appeared to be insensitive to carbon dioxide and was also relatively insensitive to hypoxia. In many ways her illness bore a similarity to that of patients with chronic mountain sickness.