Which option is an indirect cause of respiratory complications in trauma patients?

• A. Bleeding
• B. Abdominal distension
• C. Pain
• D. Bleeding, Abdominal Distension, and Pain

Answer: (D)

In trauma, respiratory complications can arise from factors that limit how well the lungs are inflated or how effectively oxygen is delivered, even when the chest itself isn’t injured. Pain from injuries makes patients guard against deep breaths, leading to shallow breathing and reduced tidal volume, which promotes atelectasis and increases pneumonia risk. Abdominal distension pushes the diaphragm upward, limiting diaphragmatic excursion and lowering lung volumes, which also raises the work of breathing and again favors atelectasis. Bleeding, even if not directly in the chest, can cause shock and reduced oxygen delivery, with compensatory rapid breathing that soon becomes fatigued and ineffective, further compromising ventilation and gas exchange. Taken together, these indirect factors provide a comprehensive set of ways trauma can impair respiration, so including all three—bleeding, abdominal distension, and pain—best captures the indirect causes.