Acute lung failure

Abstract

Lung failure is the most common organ failure seen in the intensive care unit. The pathogenesis of acute respiratory failure (ARF) can be classified as (1) neuromuscular in origin, (2) secondary to acute and chronic obstructive airway diseases, (3) alveolar processes such as cardiogenic and noncardiogenic pulmonary edema and pneumonia, and (4) vascular diseases such as acute or chronic pulmonary embolism. This article reviews the more common causes of ARF from each group, including the pathological mechanisms and the principles of critical care management, focusing on the supportive, specific, and adjunctive therapies for each condition.

© Thieme Medical Publishers.

Figures

Figure 1

The four primary alveolar processes: ventilation, diffusion, perfusion, and their regulatory mechanism hypoxic pulmonary vasoconstriction. All forms of lung failure result from a defect in one or more of these processes which culminates in V/Q mismatch, or its extreme variants shunt and dead space ventilation.

Figure 2

Comparison of therapies for different modes of lung failure. See text for details.