Although mechanical ventilation can save the lives of critically ill patients, it is associated with multiple complications. Some of them may be related temporally and not caused by ventilatory support per sé, but many are a direct result of positive-pressure ventilation. The risk of barotrauma, for example, increases with mechanical ventilation, whereas nosocomial pneumonia relies on a variety of clinical factors, one of which is concurrent intubation. In a study by Zwillich and colleagues<sup>37 Zwillich C.W., Pierson D.J., Creagh C.E. , e al. Complications of assisted ventilation Am J Med 1974 ;  57 : 161  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> prospectively examining complications in ventilated patients, more than 400 complications occurred in 354 separate episodes of ventilatory support, revealing how commonly complications arise.

Traditional reviews of mechanical ventilation have presented complications arranged by organ systems.<sup>8 Glauser F.L., Polatty R.C., Sessler C.N. Worsening oxygenation in the mechanically ventilated patient: Causes, mechanisms, and early detection Am Rev Respir Dis 1988 ;  138 : 458

Cliccare qui per andare alla sezione Riferimenti23 Pierson D.J. Complications associated with mechanical ventilation Crit Care Clin 1990 ;  6 : 711

Cliccare qui per andare alla sezione Riferimenti26 Pingleton S.K. Complications of acute respiratory failure Am Rev Respir Dis 1988 ;  137 : 1463

Cliccare qui per andare alla sezione Riferimenti34 Streiter R.M., Lynch J.P. Complications in the ventilated patient Clin Chest Med 1988 ;  9 : 127

Cliccare qui per andare alla sezione Riferimenti</sup> In this review, the authors examine the topic in a problem-oriented fashion, based on selected acute problems for which a clinician may be called to the bedside. The first section focuses on special problems encountered during the initiation of ventilatory support. In the later sections, complications are presented in the context of new events in the previously stable, ventilated patient. The authors discuss the scenarios of hypotension, acute respiratory distress, repeated triggering of the high-pressure alarm, hypoxemia, blood from the endotracheal tube, and ventilator-associated pneumonia. As will become evident, there is considerable overlap among these complications, with many complications becoming possibilities in multiple clinical scenarios. When appropriate, the reader is directed to more in-depth discussions of topics contained elsewhere in this volume or in other sources.