L6: Respiratory Failure Flashcards

(69 cards)

1
Q

Def of Respiratory Failure

A
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2
Q

Normal ABG Values

  • PaO2
  • PaCO2
  • pH
  • HCO3
  • SaO2
A
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3
Q

Types of Respiratory Failure

A
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4
Q

Classification of Acute Respiratory Failure

A
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5
Q

Classification of Acute Respiratory Failure

  • Synonyms
A
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6
Q

Classification of Acute Respiratory Failure

  • Presentation
A
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7
Q

Classification of Acute Respiratory Failure

  • CP
A
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8
Q

Classification of Acute Respiratory Failure

  • Pathogenesis
A
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9
Q

Classification of Acute Respiratory Failure

  • Etiology
A
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10
Q

Classification of Acute Respiratory Failure

  • TTT
A
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11
Q

Classification of Acute Respiratory Failure

  • Type 3
A

Perioperative respiratory failure

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12
Q

Pathophysiology of acute RF β€œHypoxemia”

A
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13
Q

Classification of Acute Respiratory Failure

  • type 4
A

Shock

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14
Q

Pathophysiology of acute RF β€œHypoxemia”

  • Hypoventilation
A
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15
Q

Pathophysiology of acute RF β€œHypoxemia”

  • Ventilation perfusion mismatch
A
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16
Q

Pathophysiology of acute RF β€œHypoxemia”

  • Diffusion Abnormalities
A
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17
Q

Pathophysiology of acute RF β€œHypoxemia”

  • Shunt
A
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18
Q

CP of ARF

A
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19
Q

CP of ARF

  • CP of Hypoxemia
A
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20
Q

CP of Hypoxemia

  • Chest Manifestations
A

β—ˆ Tachypnea β€œGood sign”
β—ˆ Dyspnea

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21
Q

CP of Hypoxemia

  • CNS Manifestations
A

β—ˆ Irritability
β—ˆ Loss of concentration
β—ˆ Convulsions
β—ˆ Coma

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22
Q

CP of Hypoxemia

  • CVS Manifestations
A

β—ˆ Pulmonary HTN
β—ˆ Core pulmonale
β—ˆ Cardiac arrest

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23
Q

CP of ARF

  • CP of Hypercapnia
A
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24
Q

CP of Hypercapnia

  • CNS Manifestations
A
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25
CP of Hypercapnia - CVS Manifestations
β—ˆ Hyperdynamic circulation β—ˆ Congested conjunctiva
26
CP of Hypercapnia - Metabolic
β—ˆ Acidosis β€œMetabolic – respiratory” β—ˆ ⇣⇣ PH – ⇑⇑ Lactic acid
27
Etiology of **ARF**
28
Etiology of **ARF** - Ventilation Disorders
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Ventilation Disorders Causing **ARF** - Ventilatory pump limitation
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Ventilation Disorders Causing **ARF** - CNS Causes
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Ventilation Disorders Causing **ARF** - Airflow Limitation
β‘  Upper airway obstruction: Acute epiglottitis – tracheal tumors β‘‘ Lower airway obstruction: Asthma – cystic fibrosis
31
Etiology of **ARF** - Diffusion Disorders
β‘  Pulmonary hemorrhage β‘‘ Pulmonary edema β‘’ Pulmonary fibrosis β‘£ Aspiration pneumonia
32
Etiology of **ARF** - Perfussion Disorders
β‘  Pulmonary Embolism β‘‘ Shock
33
Complications of **ARF**
34
Complications of **ARF** - Pilmonary
β—ˆ Pulmonary embolism β—ˆ Pulmonary fibrosis β—ˆ Nosocomial pneumonia β—ˆ Barotrauma
35
Complications of **ARF** - CVS
β—ˆ Hypotension β—ˆ ⇣⇣ COP β—ˆ Arrhythmia
36
Complications of **ARF** - GIT
β—ˆ Stress ulcer β—ˆ Paralytic ileus β—ˆ Diarrhea
37
Complications of **ARF** - Renal
ARF
38
Complications of **ARF** - Nosocomial Infection
β—ˆ Pneumonia β—ˆ UTI β—ˆ Catheter related sepsis
39
Complications of **ARF** - Nutritional
β—ˆ Malnutrition β—ˆ Hypoglycemia β—ˆ Electrolyte disturbances
40
INVx for **ARF**
41
INVx for **ARF** - Labs
42
INVx for **ARF** - Imaging
β‘  Chest X-ray β‘‘ ECHO
43
INVx for **ARF** - PFT
....
44
INVx for **ARF** - PCWP
45
Def of **PCWP**
β—ˆ It is an integrated measurement of the compliance of the left side of the heart and the pulmonary circulation β—ˆ It estimates the left atrial pressure.
46
How to measure of PCWP?
Measured through right heart catheterization
47
Interpretation of PCWP
β—ˆ Normal (<18 mmHg) β‡’ ARDS β—ˆ Increased β‡’ Cardiogenic pulmonary edema
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Significance of PCWP
To differentiate between Cardiogenic pulmonary edema & ARDS: - Bilateral basal crepitations
49
Management of **ARF**
50
Management of **ARF** - Indications of ICU Admission
51
Airway Management in **ARF**
52
Airway Management in **ARF** - Route
Endotracheal intubation
53
Airway Management in **ARF** - importance
β—ˆ Precise O2 delivery to the lungs. β—ˆ Remove secretion. β—ˆ Ensures adequate ventilation
54
Correction of Hypoxemia in **ARF**
55
Correction of Hypoxemia in **ARF** - Route
O2 administration via: - Nasal prongs – face mask - intubation - ventilation
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Correction of Hypoxemia in **ARF** - Goals
β—ˆ Adequate O2 delivery to tissues. β—ˆ PaO2 > 60 mmHg. β—ˆ SaO2 > 90%
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Correction of Hypercapnia in **ARF**
58
Correction of Hypercapnia in **ARF** - Route
β—ˆ Control the underlying cause β—ˆ Controlled O2 supply (1 -3 lit/min, titrate acc to SaO2)
59
Mechanical Ventilation in **ARF**
60
Mechanical Ventilation in **ARF** - Indications
β—ˆ Persistence hypoxemia despite O2 supply β—ˆ Decreased level of consciousness β—ˆ Hypercapnia with severe acidosis (pH< 7.2
61
Mechanical Ventilation in **ARF** - Goals
β—ˆ ⇑⇑ PaO2 β—ˆ ⇣⇣ PaCO2 β—ˆ Rest respiratory muscles
62
Noninvasive Ventilatory support (IPPV) in **ARF**
63
Noninvasive Ventilatory support (IPPV) in **ARF** - Indications
β—ˆ Mild to moderate RF β—ˆ Patient should be alert and have: - Intact airway & normal airway protective reflexes
64
Noninvasive Ventilatory support (IPPV) in **ARF** - Goals
β—ˆ Nasal or full-face mask: - Improve oxygenation - Reduce work of breathing - Increase cardiac output
65
Imdications of **Invasive MV**
66
Indications of **Non-Invasive MV**
67
TTT of **ARF** - Treatment of the underlying causes
68
When to Wean from mechanical ventilation?