L6: Respiratory Failure Flashcards
(69 cards)
1
Q
Def of Respiratory Failure
A
2
Q
Normal ABG Values
- PaO2
- PaCO2
- pH
- HCO3
- SaO2
A
3
Q
Types of Respiratory Failure
A
4
Q
Classification of Acute Respiratory Failure
A
5
Q
Classification of Acute Respiratory Failure
- Synonyms
A
6
Q
Classification of Acute Respiratory Failure
- Presentation
A
7
Q
Classification of Acute Respiratory Failure
- CP
A
8
Q
Classification of Acute Respiratory Failure
- Pathogenesis
A
9
Q
Classification of Acute Respiratory Failure
- Etiology
A
10
Q
Classification of Acute Respiratory Failure
- TTT
A
11
Q
Classification of Acute Respiratory Failure
- Type 3
A
Perioperative respiratory failure
12
Q
Pathophysiology of acute RF “Hypoxemia”
A
13
Q
Classification of Acute Respiratory Failure
- type 4
A
Shock
14
Q
Pathophysiology of acute RF “Hypoxemia”
- Hypoventilation
A
15
Q
Pathophysiology of acute RF “Hypoxemia”
- Ventilation perfusion mismatch
A
16
Q
Pathophysiology of acute RF “Hypoxemia”
- Diffusion Abnormalities
A
17
Q
Pathophysiology of acute RF “Hypoxemia”
- Shunt
A
18
Q
CP of ARF
A
19
Q
CP of ARF
- CP of Hypoxemia
A
20
Q
CP of Hypoxemia
- Chest Manifestations
A
◈ Tachypnea “Good sign”
◈ Dyspnea
21
Q
CP of Hypoxemia
- CNS Manifestations
A
◈ Irritability
◈ Loss of concentration
◈ Convulsions
◈ Coma
22
Q
CP of Hypoxemia
- CVS Manifestations
A
◈ Pulmonary HTN
◈ Core pulmonale
◈ Cardiac arrest
23
Q
CP of ARF
- CP of Hypercapnia
A
24
Q
CP of Hypercapnia
- CNS Manifestations
A
25
CP of Hypercapnia
- CVS Manifestations
◈ Hyperdynamic circulation
◈ Congested conjunctiva
26
CP of Hypercapnia
- Metabolic
◈ Acidosis “Metabolic – respiratory”
◈ ⇣⇣ PH – ⇡⇡ Lactic acid
27
Etiology of **ARF**
28
Etiology of **ARF**
- Ventilation Disorders
29
Ventilation Disorders Causing **ARF**
- Ventilatory pump limitation
29
Ventilation Disorders Causing **ARF**
- CNS Causes
30
Ventilation Disorders Causing **ARF**
- Airflow Limitation
① Upper airway obstruction: Acute epiglottitis – tracheal tumors
② Lower airway obstruction: Asthma – cystic fibrosis
31
Etiology of **ARF**
- Diffusion Disorders
① Pulmonary hemorrhage
② Pulmonary edema
③ Pulmonary fibrosis
④ Aspiration pneumonia
32
Etiology of **ARF**
- Perfussion Disorders
① Pulmonary Embolism
② Shock
33
Complications of **ARF**
34
Complications of **ARF**
- Pilmonary
◈ Pulmonary embolism
◈ Pulmonary fibrosis
◈ Nosocomial pneumonia
◈ Barotrauma
35
Complications of **ARF**
- CVS
◈ Hypotension
◈ ⇣⇣ COP
◈ Arrhythmia
36
Complications of **ARF**
- GIT
◈ Stress ulcer
◈ Paralytic ileus
◈ Diarrhea
37
Complications of **ARF**
- Renal
ARF
38
Complications of **ARF**
- Nosocomial Infection
◈ Pneumonia
◈ UTI
◈ Catheter related sepsis
39
Complications of **ARF**
- Nutritional
◈ Malnutrition
◈ Hypoglycemia
◈ Electrolyte disturbances
40
INVx for **ARF**
41
INVx for **ARF**
- Labs
42
INVx for **ARF**
- Imaging
① Chest X-ray
② ECHO
43
INVx for **ARF**
- PFT
....
44
INVx for **ARF**
- PCWP
45
Def of **PCWP**
◈ It is an integrated measurement of the compliance of the left side of the heart and the pulmonary circulation
◈ It estimates the left atrial pressure.
46
How to measure of PCWP?
Measured through right heart catheterization
47
Interpretation of PCWP
◈ Normal (<18 mmHg) ⇢ ARDS
◈ Increased ⇢ Cardiogenic pulmonary edema
48
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
◈ Precise O2 delivery to the lungs.
◈ Remove secretion.
◈ 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
56
Correction of Hypoxemia in **ARF**
- Goals
◈ Adequate O2 delivery to tissues.
◈ PaO2 > 60 mmHg.
◈ SaO2 > 90%
57
Correction of Hypercapnia in **ARF**
58
Correction of Hypercapnia in **ARF**
- Route
◈ Control the underlying cause
◈ Controlled O2 supply (1 -3 lit/min, titrate acc to SaO2)
59
Mechanical Ventilation in **ARF**
60
Mechanical Ventilation in **ARF**
- Indications
◈ Persistence hypoxemia despite O2 supply
◈ Decreased level of consciousness
◈ Hypercapnia with severe acidosis (pH< 7.2
61
Mechanical Ventilation in **ARF**
- Goals
◈ ⇡⇡ PaO2
◈ ⇣⇣ PaCO2
◈ Rest respiratory muscles
62
Noninvasive Ventilatory support (IPPV) in **ARF**
63
Noninvasive Ventilatory support (IPPV) in **ARF**
- Indications
◈ Mild to moderate RF
◈ Patient should be alert and have:
- Intact airway & normal airway protective reflexes
64
Noninvasive Ventilatory support (IPPV) in **ARF**
- Goals
◈ 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?
