Mechanical Pulmonary Failure

• • Hypoxemia

  • Hypercarbia

  • Mechanical insufficiency

Epidemiology

• • Trauma

  • Pain/weakness postoperatively

  • Debility of long-term illness

  • Bronchopleural fistula

Symptoms and Signs

• • Hypoxemia

  • Evidence of chest trauma

  • Chest pain

  • Free-floating chest wall segment

  • Large air leak via wound or chest tube

  • Poor ventilatory effort (pain, debility)

Laboratory Findings

• • Hypoxemia

  • Hypercarbia

Imaging Findings

• • Chest film: Multiple rib fractures

• • Often multifunctional basis, for example combination of injury, anesthetic, pain medications and muscle weakeners from catabolism; all factors must be addressed

• • ABG measurements

  • Chest film

• • Mechanical ventilation

  • Analgesia

  • Chest tube decompression

  • Chest wall stabilization

  • Occlusion of bronchopleural fistulas

  • Weaning and nutritional support (debility)

  • Tracheostomy (debility)

Surgery

Indications

• • Large bronchopleural fistula

References