Respiratory Support ✅ Flashcards Preview

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Flashcards in Respiratory Support ✅ Deck (112)
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1

What is respiratory failure defined as?

A syndrome of inadequate gas exchange

2

What is the result of the inadequate gas exchange in respiratory failure?

Arterial oxygen, carbon dioxide, or both cannot be maintained within their normal ranges

3

What is the normal oxygen PaO2?

>11kPa

4

What is the normal carbon dioxide PaCO2?

<6.0kPa

5

What is the normal arterial-alveolar oxygen tension difference PA-aO2?

10-25mmHg (in room air)

6

What is a drop in arterial oxygenation termed?

Hypoxaemia

7

What is a rise in arterial carbon dioxide levels termed?

Hypercapnia

8

What determines the classification of respiratory failure into type I and II?

Absence or presence of hypercapnia respectively

9

What is type 1 respiratory failure defined as?

Hypoxia without hypercapnia (PaCO2 may be normal or low)

10

What is type 1 respiratory failure typically caused by?

V/Q mismatch

11

What is meant by V/Q mismatch?

The volume of air flowing in and out of the lungs is not matched with the flow of blood to the lungs

12

What categories of conditions can cause type 1 respiratory failure?

- Parenchymal diseases
- Interstitial lung diseases
- Shunts

13

Give 3 interstitial lung diseases that can cause type 1 respiratory failure?

- ARDS
- Pneumonia
- Emphysema

14

What kind of shunt can cause type 1 respiratory failure?

Right to left shunt

15

What is type 2 respiratory failure defined as?

Hypoxia with hypercapnia

16

What is the mechanism of type 2 respiratory failure?

Inadequate ventilation

17

What are the categories of causes of type 2 respiratory failure?

- Increased airway resistance
- Neurological hypoventilation
- Neuromuscular problems
- Decreased functional residual capacity

18

Give 3 causes of increased airway resistance

- Croup
- Bronchiolitis
- Asthma

19

Give 2 causes of neurological hypoventilation

- Drug effects
- Brain stem lesions

20

Give 2 neuromuscular problems causing type 2 respiratory failure

- Guillain-Barre syndrome
- Congenital myopathy

21

Give 4 causes of reduced functional residual capacity

- Kyphoscoliosis
- Chest deformity
- Pneumothorax
- Flail chest

22

What can respiratory failure lead to if untreated?

End organ damage and death from hypoxia

23

What is the purpose of respiratory support in respiratory failure?

To prevent progression to organ damage and death, and maintain life while the underlying condition is treated

24

What does respiratory support range from?

Oxygen by face mask, to non-invasive support, endotracheal intubation and mechanical ventilation, and extracorporeal membrane oxygenation (ECMO)

25

Which children should receive oxygen support?

Children with SpO2 <92% in air

26

What happens at a SpO2 below 92%?

The oxygen haemoglobin dissociation curve becomes steep, and delivery of oxygen to the tissues becomes compromised

27

What can high concentration inspired oxygen cause?

Direct cellular toxicity and reabsorption atelectasis

28

What is the result of both high and low oxygen concentrations being damaging?

The amount of inspired oxygen should be titrated according to pulse oximetry

29

What does a fixed performance, high flow mask provide?

Fractional inspired oxygen concentration (FiO2) within range of 0.26-0.6

30

When might the FiO2 not be known?

With the more common variable performance masks, or with nasal cannulae