Holcroft J W, Trunkey D D
Surg Annu. 1983;15:1-12.
The respiratory failure that develops in surgical patients is usually caused by a surgical problem--shock, trauma, sepsis, pulmonary contusion, aspiration, pulmonary emboli or pain, with its attendant ventilatory compromise. Although the underlying pathophysiology for the respiratory failure in these conditions is not precisely known, the means for prevention are well known. Patients subjected to trauma should be aggressively resuscitated from shock. They should have the chance of being cared for in a facility where an operation can be performed promptly. The respiratory failure of sepsis is best treated by seeking out foci of pus or devitalized tissue and surgically ablating these foci when found. Adherence to these basic surgical principles--aggressive resuscitation of patients in shock and prompt attention to their surgical problems--will alleviate much of the respiratory distress of surgical patients, no matter what the pathophysiology or etiology may be.
外科患者发生的呼吸衰竭通常由外科问题引起，如休克、创伤、脓毒症、肺挫伤、误吸、肺栓塞或疼痛及其伴随的通气功能受损。虽然这些情况下呼吸衰竭的潜在病理生理学机制尚不完全清楚，但预防方法是众所周知的。遭受创伤的患者应积极抗休克复苏。他们应有机会在能迅速进行手术的机构接受治疗。脓毒症所致的呼吸衰竭最好通过寻找脓灶或失活组织病灶，并在发现时通过手术切除这些病灶来治疗。坚持这些基本的外科原则——积极抗休克复苏患者并及时关注其外科问题——将减轻外科患者的许多呼吸窘迫，无论其病理生理学机制或病因如何。
