Resp Failure Flashcards Preview

Pulmonology 2 > Resp Failure > Flashcards

Flashcards in Resp Failure Deck (28):
1

WHat is Respiratory Failure?

Lungs fail to adequately oxygenate arterial blood and/or Prevent retension of CO2

Consequence of underlying conditions

2

WHat is Acute Respiratory Failure?

Abrupt onset with rapid progression
Sometimes reversible

3

WHat is Chronic Respiratory Failure?

Slow onset and progression
irreversible

4

What is Acute on ChronicRespiratory Failure?

increased baseline O2 requirements
Increase CO2 above baseline enough to drop pH

5

What are ventilation causes of Acute Resp Failure?

Drug overdose

6

What are oxygenation causes of Acute Resp Failure?

Pneumonia

7

What are ventilation causes of Chronic Resp Failure?

Neuromuscular Disease

8

What are oxygenation causes of Chronic Resp Failure?

Pulmonary Fibrosis

9

WHat are the types of Respiratory Failure?

Hypoxemic Resp Failure
Hypercapnic Resp failure###

10

What are the causes of Hypoxemia?

Host
-Hypoventilation
-Diffusion impairment
-Shunt
-V/Q mismatch
Environment
-Low FiO2

11

What are the clinical Manifestations of Tissue Hypoxia?

Resp
-Cyanosis
-Tachypnea
CV
-Tachycardia
-Hypertension
CNS
-Confusion
Lactic Acidosis
Low SpO2
Other Organ Failure

12

What are common conditions that Can lead to Resp Failure?

Cardiac Dysfunction
Pulm infection or Aspiration
Venous Thromboembolus
Obstructive Lung disease
Pleural Disease
-Pneumothorax
-Effusion
Chest Trauma
-contusion
-hemothorax

13

What is the P/F Ratio

Ratio of Oxygen delivery to Arterial Oxygen

14

What is done to give initial support to a Pt in Resp Failure?

Supplemental O2
IV Acess
Vital Sign monitoring
-SpO2
-HR
-BP
-EKG

15

What drugs are given to Support someone in resp failure?

Chronotropes
Ionotropes
Arrhythmia Control

Vasodilators in CHF

16

What are the goals in Advanced support in Resp Failure?

Hb Conc > 7
COutput
-IVF 30ml/kg
-Vasopressors
Goal Lactic Acid

17

WHat are the affects of CO2 on pH?

Acute rise of 10 = dec pH by 0.08
Acute drop of 10 = raise pH by 0.08
Chronic rise of 10 = dec pH by 0.03
Chronic drop of 10 = Raise pH by 0.03

18

What are the effects of CO2 changes on Bicarb concetrations?

Acute Resp Acidosis: CO2 +10 = Bicarb +1
Chronic Resp Acidosis: CO2 +10 = Bicarb +3
Acute Resp Alkalosis: CO2 -10 = Bicarb -2
Chronic Resp Alkalosis: CO2 -10 = Bicarb -5

19

What is the treatment of Chronic Respiratory Failure?

Smoking cessation
Vaccination
Oxygen therapy
Mech Ventilation
Supportive Care and ED
Nutrition (wt loss/gain)
Pulm Rehab
Transplantation
Palliation

20

What are the vaccines that COPD patients need to recieve?

Pertussis
Influenza
Pneumococcal

21

What are the effects of oxygen therapy in COPD?

Improves survival, dyspnia, and Exercise Tolerance
No improvement in Lung function, or survival in Pts with Moderate or nocturnal Hypoxemia

22

What qualifies someone for Oxygen therapy?

PaO2

23

What are the Absolute Contraindications for Lung Transplant?

Absolute:
Major organ dysfunction
HIV
Hep C/B
Active Malignancy
Substance abuse
Non-osteoporotic musculoskeltal disease

24

What are the Relative Contraindications for Lung Transplant?

Systemic or Multisystem dz
Active infection
Resistant microorganisms
Osteoporosis
Mech Ventilation
BMI >30
Steroids

25

WHat are signs of Chronic Respiratory failure?

Polycythemia
Elevated CO2
Nomral pH w/ elevated PaCO2
Elevated Bicarb
Clubbing

26

What are adverse effects of O2 administration in someone with Respiratory failure?

Hypercapnia 2/2
increased physiologic dead space from V/Q mismatch
Attenuated hypoxic ventilatory drive
Haldane effect

27

What is the Haldane effect?

Deoxygenation of the blood increases its ability to carry carbon dioxide.
Conversely, oxygenated blood has a reduced capacity for carbon dioxide.

28

What are the causes of Hypercapnia?

(Increased CO2)
Hypoventilation(drive)
Neuromuscular
Body Habitus
Drugs
Increased Production
-Sepsis, fever, burns, trauma, seizures
Airway obstruction
Resp muscles
V/Q mismatch