ABSTRACT
Respiration is a complex physiologic process that involves coordinated functioning of the different components of the respiratory system. This chapter provides the basics of mechanical ventilation as applied to the management of acute respiratory failure, the evidence behind the strategies used to treat acute respiratory distress syndrome (ARDS), and some less common causes of respiratory failure that are unique to surgical and trauma patients. Risk factors may primarily be patient-related, procedure-related, or a combination of the two. Patient-related risk factors include smoking, poor general health status, chronic obstructive pulmonary disease, and asthma. Preoperative education of patients about the techniques for lung expansion, deep-breathing exercises, and the use of incentive spirometry is beneficial. Endotracheal intubation, a key component of positive-pressure mechanical ventilation, is associated with several complications such as upper airway trauma, nosocomial pneumonia, and sinusitis. An important advancement in the management of ARDS has been the recognition of the beneficial effects of lung-protective ventilation strategies.
