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Acute Respiratory Failure and Acute Respiratory Distress Syndrome in ACS Patient: What Are the Indications for Acute Intervention?

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Intensive Care for Emergency Surgeons

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

Abstract

An understanding of respiratory failure and acute respiratory distress syndrome (ARDS) is paramount to the knowledge base of an emergency general surgeon as their trauma and surgical patients are at-risk populations. Respiratory failure and postoperative pulmonary complications (PPC) can be caused by a wide range of pre-existing and new onset disease conditions and manifest clinically as hypoxemia or hypercapnia. One of the most severe forms is ARDS, a complex syndrome of hypoxemic respiratory failure incited by a separate underlying disease, such as intraabdominal sepsis, aspiration, pneumonia, or trauma, all conditions frequently encountered by the surgeon. The hallmark findings are the acute development of non-cardiogenic bilateral pulmonary infiltrates with refractory hypoxemia. PPCs are the most common postoperative complication developed by surgical patients, with resulting increases to morbidity and mortality. Despite significant advances in the understanding and management of ARDS patients specifically, in-hospital mortality still exceeds 40% in most settings with survivors also at risk for long-term disability. Prompt recognition and initiation of appropriate treatment strategies can improve patient outcomes for all forms of respiratory failure. This chapter will provide a practical overview of the diagnosis, pathophysiology, risk factors, and interventions the surgeon should be familiar with to properly care for patients with respiratory failure and ARDS.

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Authors and Affiliations

  1. The Medical College of Wisconsin, Department of Surgery, Division of Trauma and Acute Care Surgery, Milwaukee, WI, USA

    Jacob R. Peschman & Marc de Moya

Authors
  1. Jacob R. Peschman
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  2. Marc de Moya
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Correspondence to Jacob R. Peschman .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy

    Edoardo Picetti

  2. Division of Trauma, Department of Surgery, University of Campinas, Campinas, São Paulo, Brazil

    Bruno M. Pereira

  3. Department of Surgery, McGill University, Montreal, QC, Canada

    Tarek Razek

  4. Department of Surgery/ Division of Trauma, Burns, Critical and Acute Care, Weill Cornell Medicine/ New York-Presbyterian Hospital, New York, USA

    Mayur Narayan

  5. Department of Surgery, Tel Aviv University, Tel Aviv, Israel

    Jeffry L. Kashuk

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Peschman, J.R., de Moya, M. (2019). Acute Respiratory Failure and Acute Respiratory Distress Syndrome in ACS Patient: What Are the Indications for Acute Intervention?. In: Picetti, E., Pereira, B., Razek, T., Narayan, M., Kashuk, J. (eds) Intensive Care for Emergency Surgeons. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-11830-3_2

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  • DOI: https://doi.org/10.1007/978-3-030-11830-3_2

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