LUNG FAILURE AND LIMITS OF ARTIFICIAL-VEN TILATION

The treatment and outcome of the respiratory failure decisively depend on its pathophysiological background. Besides simple blood gas analys is the investigation of the respiratory mechanics, interstitial lung w ater and the monitoring of the pulmonary pressure are necessary for an exact diagnosis. As a scoring method of lung failure the classificati on by Murray and Morell is most common. In addition to normal volume o r pressure controlled artificial ventilation the treatment of lung fai lure sometimes requires new but accepted modes of ventilation as inver sed ratio ventilation, permissive hypercapnea and high frequency venti lation. New methods as negative pressure ventilation, extracorporeal l ung ventilation and liquid or partial liquid ventilation are not commo n yet and should be used only under special conditions. As a supplemen t of these modes of ventilation the application of prostacyclins, nitr ic oxide, surfactant and inhibitors of the arachidonic pathway is unde r clinical investigation. A limitation of the treatment of lung failur e should be considered in irreversible multiple organ failure.