The management of acute respiratory failure.

The mortality rate of severe respiratory failure in most centers remains 60% to 90% with conventional pulmonary support techniques. Recent advances in the physiologic management of patients with acute respiratory failure include optimizing systemic oxygen delivery as reflected by continuous mixed-venous saturation monitoring, avoidance of the damaging effects of high inflation pressures and volumes during mechanical ventilation, and the increasing application of extracorporeal life support techniques for refractory respiratory failure. The future promises the routine clinical application of novel support techniques including implantable intracorporeal gas exchange devices and perfluorocarbon liquid ventilation.