[Respiratory insufficiency in the surgical intensive care unit]

Postoperative pulmonary complications are of clinical importance: they prolong the hospitalization, increase the costs of treatment and contribute to the perioperative mortality. Respiratory insufficiency--inability to maintain adequate exchange of gases in the lungs--is its most severe form. Early diagnostics is essential and it is possible only during continuous and meticulous surveillance of the patient. In the postoperative period there are factors present enhancing the development of the postoperative pulmonary complications: drugs, pain, influence of the trauma of the operation, decreased lung capacity and decreased mobility. Prevention of complications is essential. Its indispensable part is adequate preoperative preparation, as well as good management of anaesthesia. The cornerstones of adequate postoperative care are oxygen therapy, sufficient analgesia, physiotherapy. At the earliest signs of respiratory insufficiency the commencement of respiratory support is mandatory. Artificial ventilation can be used as a preemptive measure preventing the development of pulmonary complications.