Therapy of adult respiratory failure after hemorrhage and trauma based on an analysis of antecedent physiologic determinants

  • William C. Shoemaker
Part of the Developments in Critical Care Medicine and Anaesthesiology book series (DCCA, volume 1)


Many physiologic and chemical mechanisms have been incriminated in the pathogenesis of respiratory failure or adult respiratory distress syndrome (ARDS) [1–11]. The relevance of these proposed mechanisms remains unclear because they have not been related to the natural history of this clinical disorder. Since it is tacitly assumed that patients develop ARDS from a baseline of normal hemodynamic and respiratory values, it follows that cardiorespiratory changes in ARDS should be compared with normal values. This conventional approach focuses on altered lung function and gas exchange after the symptom complex has become clinically manifest; it tends to ignore antecedent circulatory and peripheral oxygen transport changes that, having precipitated the disorder, probably have pathogenic relevance.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bendixen HH, Egbert LD, Hedley-Whyte J, Laver MB, Pontoppidan H: Respiratory care. St Louis: CVMosby, 1965.Google Scholar
  2. 2.
    Nunn JF: Applied respiratory physiology. London: Butterworths, 1969.Google Scholar
  3. 3.
    Teplitz C: Ultrastructural basis for pulmonary pathophysiology following trauma. J Trauma 8: 700, 1968.PubMedCrossRefGoogle Scholar
  4. 4.
    Pontoppidan H, Geffin B, Lowenstein B: Acute respiratory failure in the adult. N Engl J Med 287:690, 743, and 799, 1972.PubMedCrossRefGoogle Scholar
  5. 5.
    Jenkins MT, Jones RF, Wilson B, et al: Congestive atelectasis: a complication of the intravenous infusion of fluids. Ann Surg 132: 327, 1950.PubMedCrossRefGoogle Scholar
  6. 6.
    Sealy WC, Ogino S, Lesage AM, et al: Functional and structural changes in the lung in hemorrhagic shock. Surg Gynecol Obstet 122: 754, 1966.PubMedGoogle Scholar
  7. 7.
    Shoemaker WC, Appel P, Czer LSC, et al: Pathogenesis of respiratory failure (ARDS) after hemorrhage and trauma: I. Cardiorespiratory patterns preceding the development of ARDS. CritCare Med 8: 504, 1980.PubMedCrossRefGoogle Scholar
  8. 8.
    Petty TL, Ashbaugh DG: The adult respiratory distress syndrome — clinical features and factors influencing prognosis and principles of management. Chest 70: 233, 1971.Google Scholar
  9. 9.
    Hopewell PC, Murray JF: The adult respiratory distress syndrome. Ann Rev Respir Med 27: 343, 1976.CrossRefGoogle Scholar
  10. 10.
    Bates DV, Christie RV: Respiratory function in desease: an introduction to the integrated study of the lung, 2nd edn. Philadelphia: WB Saunders, 1971.Google Scholar
  11. 11.
    Comroe JH, Forster RE, DuBois AB, Briscoe WA, Carlsen E: The lung: clinical physiology and pulmonary function tests, 2nd edn. Chicago: Year Book Medical Publishers, 1962.Google Scholar
  12. 12.
    Shoemaker WC: Pathophysiology, monitoring and therapy of shock syndromes. In: Shoemaker WC, Thompson WL (eds) Critical care state of the art. Fullerton CA: Society of Critical Care Medicine, 1980, p I (D): 1.Google Scholar
  13. 13.
    Shoemaker WC, Czer L, Chang P, Shabot MM, State D: Cardiorespiratory monitoring in postoperative patients: I. Prediction of outcome and severity of illness. Crit Care Med 7: 237, 1979.PubMedCrossRefGoogle Scholar
  14. 14.
    Shoemaker WC, Appel PL, Waxman K, Schwartz S, Chang P: Use of survivors’ cardiorespiratory patterns as criteria for therapy in critically ill patients. Arch Surg (in press).Google Scholar
  15. 15.
    Shoemaker WC, Chang P, Bland R, et al: Cardiorespiratory monitoring in postoperative patients: II. Quantitative therapeutic indices as guides to therapy. Crit Care Med 7: 243, 1979.PubMedCrossRefGoogle Scholar
  16. 16.
    Blaisdell FW, Lewis FR: Respiratory distress syndrome of shock and trauma. Philadelphia: WB Saunders, 1977.Google Scholar
  17. 17.
    Kim S-I, Desai JM, Shoemaker WC: Sequential respiratory changes in an experimental hemorrhagic shock preparation designed to simulate clinical shock. Ann Surg 170: 166, 1969.PubMedCrossRefGoogle Scholar
  18. 18.
    Tiefenbrun J, Shoemaker WC: Sequential changes in pulmonary blood flow distribution in hemorrhagic shock. Ann Surg 174: 727, 1972.CrossRefGoogle Scholar
  19. 19.
    Shoemaker WC, Montgomery ES, Kaplan E, Elwyn DH: Physiologic patterns in surviving and nonsurviving shock patients. Arch Surg 106: 630, 1973.PubMedCrossRefGoogle Scholar
  20. 20.
    Kin S-I, Shoemaker WC: Role of the acidosis in the development of increased pulmonary vascular resistance and shock lung in experimental hemorrhagic shock. Surgery 73: 723, 1973.Google Scholar
  21. 21.
    Shoemaker WC: Pattern of pulmonary hemodynamic and functional changes in shock. Crit Care Med 2: 200, 1974.PubMedCrossRefGoogle Scholar
  22. 22.
    West JB, Dollery CT, Naimark A: Distribution of blood flow in isolated lung related to vascular and alveolar pressures. J Appl Physiol 19: 173, 1964.Google Scholar
  23. 23.
    Permutt S, Riley RL: Hemodynamics of collapsible vessels with tone: the vascular waterfall. J Appl Physiol 18: 924, 1963.PubMedGoogle Scholar
  24. 24.
    Tiefenbrun J, Kim S-I, Shoemaker WC: Relationship of the distribution of pulmonary blood flow to lung function in hemorrhagic shock. Surg Gynecol Obstet 138: 557, 1974.PubMedGoogle Scholar
  25. 25.
    Tiefenbrun J, Dikman S, Shoemaker WC: The correlation of sequential changes in the distribution of pulmonary blood flow in hemorrhagic shock with the histopathologic anatomy. Surgery 78: 618, 1975.PubMedGoogle Scholar
  26. 26.
    Shoemaker WC, Bryan-Brown CW, Quigley L, et al: Body fluid shifts in depletion and post- stress states and their correction with adequate nutrition. Surg GynecolObstet 136: 371, 1973.PubMedGoogle Scholar
  27. 27.
    Baek SM, Makabali GG, Bryan-Brown CW, et al: Plasma expansion in surgical patients with high central venous pressure. Surgery 78: 304, 1975.PubMedGoogle Scholar
  28. 28.
    Czer LSC, Appel P, Shoemaker WC: Pathogenesis of respiratory failure (ARDS) after hemorrhage and trauma: II. Cardiorespiratory patterns after development of ARDS. Crit Care Med 8: 513, 1980.PubMedCrossRefGoogle Scholar
  29. 29.
    Bland R, Shoemaker WC, Shabot MM: Physiologic monitoring goals for the critically ill patient. Surg Gynecol Obstet 147:833,1978.,PubMedGoogle Scholar
  30. 30.
    Shoemaker WC, Pierchala C, Chang P, State D: Prediction of outcome by analysis of the frequency distributions of cardiorespiratory variables. Crit Care Med 5: 82, 1977.PubMedCrossRefGoogle Scholar
  31. 31.
    Shoemaker WC, Appel PL, Bland R, Hopkins J A, Chang P: Clinical trials of an algorithm for outcome prediction in acute circulatory failure. Arch Surg (in press).Google Scholar
  32. 32.
    Hauser CJ, Shoemaker WC, Turpin I, Goldberg SJ: Hemodynamic and oxygen transport responses to body water shifts produced by colloids and crystalloids in critically ill patients. Surg GynecolObstet 183: 8, 1980.Google Scholar
  33. 33.
    Appel PL, Shoemaker WC: Evaluation of fluid therapy in acute respiratory failure. Crit Care Med 9: 873, 1981.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1982

Authors and Affiliations

  • William C. Shoemaker

There are no affiliations available

Personalised recommendations