Management of severe respiratory failure in complex trauma patients

Acute respiratory failure represents a major challenge in the management of complex trauma patients. Both direct thoracic injury and extrathoracic injury can lead to respiratory failure. The pathophysiologic mechanisms underlying respiratory failure in this setting can vary. Successful management of severe respiratory failure in complex trauma patients requires an understanding of these pathophysiologic processes and careful attention to multiple treatment priorities. Lung-protective ventilation strategies, judicious fluid management, and the use of rescue modalities are discussed in this review.