RT Book, Section
A1 Halaweish, Ihab
A1 Delano, Matthew J.
A1 Alam, Hasan B.
A2 Moore, Ernest E.
A2 Feliciano, David V.
A2 Mattox, Kenneth L.
SR Print(0)
ID 1141192300
T1 Respiratory Insufficiency
T2 Trauma, 8e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071847292
LK accesssurgery.mhmedical.com/content.aspx?aid=1141192300
RD 2024/04/19
AB The  maintenance  of  gas  exchange  may  be  tenuous  in  the  injured  patient  because  of  dysfunction  in  three  key  elements  of  the  respiratory  system.  First,  the  central  nervous  system  may  be  impaired,  resulting  in  inadequate  respiratory  drive,  or  inability  to  maintain  patent  proximal  airways.  Second,  injury  to  the  torso  can  produce  changes  in  compliance,  ineffective  respiratory  effort,  and  pain  that  impact  the  patient’s  ability  to  complete  the  work  of  breathing.  Third,  primary  and  secondary  insults  to  the  lung  result  in  ineffective  gas  exchange.  In  practice,  it  is  common  for  patients  to  suffer  simultaneous  insults,  affecting  all  three  elements.  Respiratory  failure  that  relates  primarily  to  CNS  injury  is  discussed  at  length  in  other  chapters  and  will  not  be  extensively  covered  here.  This  chapter  will  focus  on  insults  that  affect  work  of  breathing  and  gas  exchange.  The  syndrome  of  acute  respiratory  distress  syndrome  (ARDS)  and  current  management  is  a  major  focus.