Therapy of adult respiratory failure after hemorrhage and trauma based on an analysis of antecedent physiologic determinants
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.
- 1.Bendixen HH, Egbert LD, Hedley-Whyte J, Laver MB, Pontoppidan H: Respiratory care. St Louis: CVMosby, 1965.Google Scholar
- 2.Nunn JF: Applied respiratory physiology. London: Butterworths, 1969.Google Scholar
- 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
- 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.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.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
- 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
- 16.Blaisdell FW, Lewis FR: Respiratory distress syndrome of shock and trauma. Philadelphia: WB Saunders, 1977.Google Scholar
- 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
- 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
- 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.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