Perioperative respiratory failure is usually caused by atelectasis. Effective means of preventing or treating atelectasis include incentive spirometry, ensuring adequate analgesia for chest and abdominal incisions, upright positioning, and early mobilization. Atelectasis caused by abdominal distention should be alleviated according to the cause (eg, nasogastric suction for excessive intraluminal air, paracentesis to evacuate tense ascites).
Hypoperfusion, regardless of cause, may result in respiratory failure through inadequate delivery of O2 to respiratory muscles coupled with excess respiratory muscle load (eg, acidosis, sepsis). Mechanical ventilation is useful for diverting blood flow from overworked respiratory muscles to critical organs such as the brain, kidney, and gut.
Last full review/revision August 2007 by Brian K. Gehlbach, MD; Jesse B. Hall, MD