290 - Disorders of Ventilation Flashcards
What is the normal PaCO2 in arterial blood?
37-43
Disease affecting CO2 production are usually __ (__/__/__)
acute
sepsis
burn
fever
Chronic ventilation disorders usually relate to __ __ changes or increased __.
minute ventilation
dead space
What are the main categories of hypoventilation disease?
pulmonary/chest wall parenchyma disease
poor disorders
neuromuscular disorders
respiratory drive disorders
The clinical course of patients with chronic hypoventilation is characterized by:
1- asymptomatic stage during the day
2- sleep hypoventilation
3- hypercapnia during the day
The lab will show in increase of plasma __, without decreased __ volume- meaning there is __.
HCO3
plasma
hypoventilation
ABG will show increased __ with normal __- suggesting chronic ___ hypoventilation.
PaCO2
pH
alveolar
minute ventilation=___
the amount of air breathed per minute
__ examination, imaging (__/__), and ___ are usually sufficient in diagnosing the different disorders leading to hypercapnia.
physical
CT/CXr
pulmonary function tests
If the examinations did not find a specific etiology, suspect- __.
OHS
OHS-__
obesity hypoventilation syndrome
OHS usually comes together with __.
OSA
Which criteria are used to diagnose OSA? 3
STOP BANG
ESS
Berlin
What is the next thing to suspect if OHS is overruled? 2
neuromuscular disorder central disorder (respiratory drive)
NIPPV is a non __ ventilation with __ pressure for patients with chest wall or neuromuscular respiratory disorders.
invasive
positive
Consider NIPPV in ALS patients if hypoventilation with one of the following: 5
PaCO2>= 45 mmHg sleep oximetry during sleep < 88% for >5 minutes maximal inspiratory pressure < 60 cmH2O FVC < 50% of expected sniff nasal pressure < 40 cmH2O
Phrenic nerve or diaphragm __ is a potential therapy for patients with hypoventilation from high __ lesions or respiratory drive disorders.
pacing
cervical spinal cord
OHS diagnosis requires: 2
BMI >= 30kg/m2
PaCO2>=45mmHg (chronic alveolar hypoventilation)
OHS treatment involves: 2
weight loss
sleep NIPPV
OHS patients can use __ if CPAP is not well tolerated.
BiPAP
Patients with OHS and without OSA can start with __ directly. True also for patients with __ OHS deterioration.
BiPAP
acute
Central hypoventilation syndrome are unresponsive to __ or __. They suffer from increased __ while awake, and even worse while __.
hypoxia
hypercapnia
PaCO2
sleeping
Central hypoventilation syndrome treatment involves: 3
NIPPV
mechanical ventilation
phrenic nerve/diaphragm pacing
