2. Respiratory Restrictive Flashcards
restrictive lung disease
inability to increase lung volume
restrictive lung disease causes
decr lung expansion
decr lung compliance
mild RLD
65-80%
mod RLD
50-65%
sev RLD
< 50%
RLD DLCO
reduced DLCO
do you need to change induction or mx drugs for RLD
no
regional anesthesia for RLD
good choice
avoid sensory/motor T10 block
acute intrinsic
pulm edema
ARDS
pulm edema
batwing
normal
which xray shows a batwing
pulm edema
atelectasis due to right mainstem
atelectasis with tracheal deviation and mainstem
pneumothorax
pneumonia
pulm edema goal
optimize cardiorespiratory function
pule edema respiration
mechanical vent with PEEP
RR 14-18
PIP < 30 cmH2O
ARDS
inflammatory injury to lung that results in acute respiratory failure
Berlin definition of ARDS
oxygenation
timing
imaging
mild oxygenation
200 < PaO2/FiO2
mod oxygenation
100 < PaO2/FiO2
severe oxygenation
PaO2/FiO2
how is oxygenation calculated
with CPAP or PEEP of at least 5 cm H2O
ARDS timing of onset
within 7 days of known clinical insult
ARDS imaging results
bilateral opacities not explained by other cuases
ARDS management
fix the cuase
ARDS TV management
4-6mL/kg (lower is more protective)
minimize FiO2
chronic intrinsic RLD
pulm fibrosis
sacroidoiss
pneumonia
bronchopulmonary dysplasia
sarcoidosis
systemic granulomatous disease
can cause endobronchial and endotracheal granulomas
(fibrosis of lungs and larynx)
IRLD have ____ FRC
small FRC
IRLD anesthetic uptake
faster bc lower FRC
how do you reduce barotrauma
decr PIP
extrinsic lung disease
disorder of thoracic cage interfereing with lung expansion
ELD conditions
ankylosing spondylitits
flail chest
scoliosis
kyphosis
kyphosis
anterior flexion
lordosis
posterior flexion
ankylosing spondylossi
vertebral body fusion
kyphotic spine
kyphoscoliosis causes
> 70 degrees: incr risk of resp dysfunction
100 deg: severe
flail chest
multiple rib fractures (3+) causing paradoxical chest wall movement
flail chest compliance
decr
flail chest TV and FRC
decr TV
decr FRC
flail chest work of breathing
incr
pleural effusion
accumulation of fluid in pleural space
pleural effusion diagnosis
xray
or
CT
hemothorax
blood
chylothorax
lymph
empyema
pus
hydrothorax
serous liquid
pleural effusion treatment
thoracentesis
pleural effusion xray
pleural effusion CT
pneumothroax
air in pleural space
2 causes of pnuemo
spontaneous - no known lung pathology
secondary - know lung pathology
tension pneumo
air enters during inspiration but cant escape during expiration
incr pressure in pleural space
pnuemothorax
what indicates tension pneumo in awake pt
resp distress
incr RR
sob
hypoxia
tachycardia
hyptension
decr breath sounds on one side
indications of tension pneumo in mech vent patient
incr PIP
decr TV on Pressure control
tension pneumo treatment
needle decompression
chest tube
100% FiO2
mediastinal mass complications
CV collapse
airway collapse
mediastinal mass can compress
trachea
brochus
SVC
what position should you induce pt in for mediastinal mass
sitting position
airway managment for media stinal mass
awake fiberoptic
or
rigid bronchoscope
spinal cord injury below C4
impaired cough
loss of abdomial tone = loss of diaphragm efficiency
obesity causes
decr FEV1
decr FVC
decr FRC
decr ERV
when if FRC less than closing capacity
BMI > 40
what corresponds to respiratory compromised
waist to hip ratio