Abstract
Acute respiratory failure occurs when the lungs fail to oxygenate arterial blood adequately and it is one of the commonest postoperative complications. The preoperative identification of risk factors for postoperative acute respiratory failure allows identification of those patients who may benefit from preoperative optimization and increased postoperative vigilance. Multiple postoperative pulmonary complications are associated with acute hypoxemic respiratory failure and this chapter discusses atelectasis, pulmonary embolism, aspiration, and acute respiratory distress syndrome in detail, as well as providing a unified clinical approach to the acutely hypoxemic perioperative patient.