Respiratory Failure in Shock

Pulmonary mechanics and diffusion after 'shock lung'.

“…From the present results it appears that these disturbances are, at least partly, irreversible. It should be emphasized that these disturbances of diffusing properties of the lung are present without any sign of pulmonary fibrosis, which is known to develop in fatal cases (Hardaway et al, 1967;Wilson et al, 1969;Bredenberg et al, 1969): pulmonary compliance and total lung capacity are indeed perfectly normal in all seven cases.…”

The lung in shock: A review

“…The clinical picture is improved, but hyperventilation persists, with resultant hypocapnia. 6 The patient also shows increasing venous admixture. The physiological shunt across the lungs may be 10 per cent to 20 per cent of the cardiac output.…”

“…perfused but non-ventilated broncho-alveolar segments. 6 Normally the true venous shunt (on breathing 100 per cent O2 ) is about 3 per cent of the cardiac output and is due to blood Row through bronchial or coronary vessels which empty directly into the left heart.…”

“…6 In practice, one may have to accept a P0 2 of lower than 100 Torr (70 mm Torr Hg). Adequacy of tissue oxygenation can be assessed, to a degree, by measurement of lactate levels.…”

Massive Trauma

“…Most of these late deaths fol¬ lowing trauma have resulted from pulmonary insufficiency. [1][2][3][4][5][6] We have postulated that intravas¬ cular coagulation results from tis-sue injury and that this is the in¬ termediary lesion responsible for most of the pulmonary changes and for much of the associated organ failure.1…”