Mechanical ventilatory support

This article considers selected aspects of the diagnosis and management of acute respiratory failure in postoperative patients. The discussion is limited to aspects of acute pulmonary injury such as pneumonia, postoperative and posttraumatic disease, and nonspecific syndromes commonly considered under the general heading of 'adult respiratory distress syndrome.' Acute respiratory failure occurring in conjunction with chronic obstructive pulmonary disease entails diagnostic considerations, different from those of acute respiratory failure is thus omitted. We review the clinical settings in which acute respiratory failure may occur in surgical patients; we also examine its clinical recognition, pathophysiology, and therapeutic principles.