CAUSES OF PROGRESSIVE PULMONARY INSUFFICIENCY IN SURGICAL PATIENTS

Life-threatening progressive pulmonary insufficiency of obscure etiology in seriously ill surgical patients may be the result of several contributing factors. Peritonitis, general anesthesia, aspiration, and increased susceptibility to gram negative pulmonary infections are all of reasonably established importance. Fluid overload, fat embolism, and oxygen toxicity can be major factors in appropriate patients. Sepsis, intravascular coagulation, shock, and extensive transfusion are potentially very important. Their respective roles have not been defined but sepsis may be of great importance, transfusion and shock much less. The diversity of background in clinical cases makes it likely that no single factor is always dominant; the additive or synergistic effects of several factors together may be the critical determinant. © 1969.