3 - Mechanical Ventilation

adequately ventilate), or both hypoxic and hypercapnic. In addition, respiratory failure can be caused by an inability to protect the airway. Alterations in the normal physiology and anatomy of the respiratory system can lead to respiratory failure requiring mechanical ventilation. Anatomic alterations causing airway obstruction, such as tumors, edema, direct or indirect trauma, burns, or other such pathology, may result in respiratory failure. Central nervous system alterations caused by traumatic brain injury, intoxicants, and hemorrhagic or ischemic stroke can cause overt respiratory failure or loss of protective reflexes. Diseases of the peripheral nervous system may result in hypoventilation. Primary pulmonary diseases such as pneumonia can be manifested as ventilation-perfusion mismatch. Asthma and chronic obstructive pulmonary disease (COPD) can lead to hypercapnic respiratory failure. Cardiovascular disease may be accompanied by respiratory failure secondary to acute cardiogenic pulmonary edema, cardiac arrest, myocardial infarction, acute valvular insufficiency, cardiomyopathy, or arrhythmias. Finally, global states such as shock from any cause can lead to respiratory failure.