Acute Respiratory Failure

Question 1

What is ACUTE RESPIRATORY FAILURE?

Answer 1

Acute respiratory failure develops over minutes to hours (bronchial asthma attack, lobar
pneumonia). Acute respiratory failure is characterized by life-threatening derangements in
arterial blood gases and acid-base status.

Question 2

What are the causes of APF?

Answer 2

• Airways obstruction (aspiration of foreign body, vomit, blood or other fluids; allergic
  swelling of the larynx; laryngospasm; bronchial asthma attack).
• Lung affection (pulmonary embolism, lobar pneumonia, pneumothorax, pulmonary edema
  and massive pleural effusion.
• Acute Respiratory Distress Syndrome (ARDS).
• Injuries (fracture of the ribs, injure of the chest, injury to the spinal cord).
  -Drug or Alcohol overdose.
  -Chemical Inhalation.
• Central nervous system disorders (craniocerebral trauma, stroke, neuro infections).

Question 3

What are complaints?

Answer 3

The main complaints in the case of acute respiratory failure are dyspnea, restlessness, and
anxiety.

Question 4

What can you observe in physical examination?

Answer 4

• confusion or alteration of consciousness,
• cyanosis,
• tachypnea,
• tachycardia,
• diaphoresis.
• Cardiac arrhythmia and coma
  Jugular venous distention occurs with high levels of positive end-expiratory pressure or
  right ventricular failure.

Question 5

What are the investigations done?

Answer 5

• Measuring arterial blood gases: This emphasizes the
importance of measuring arterial blood gases in all patients who are seriously ill or in
whom respiratory failure is suspected.
• Pulse oximetry: is necessary to control severity of respiratory failure and efficiency of
treatment.
• Chest radiography is essential.
• Echocardiography is not routinely done but is sometimes useful.
• Electrocardiography (ECG) should be performed to evaluate the possibility of a
cardiovascular cause of respiratory failure; it also may detect dysrhythmias resulting from
severe hypoxemia or acidosis

Question 6

how can I treat ARF?

Answer 6

• Patients with acute respiratory failure need to be admitted to the intensive care unit for
  ventilatory support.
• Hypoxemia is the major immediate threat to organ function.
• The goal of treatment is to assure adequate oxygen delivery to tissues, generally
  achieved with an arterial oxygen tension (Pa 02) of 60 mm Hg or an arterial oxygen
  saturation (Sa 02) greater than 90%.
• Supplemental oxygen is administered via nasal prongs or face mask; however, in patients
  with severe hypoxemia, intubation and mechanical ventilation are often required.
• After the patient’s hypoxemia is corrected and the ventilatory and hemodynamic status
  have stabilized, The specific
  treatment depends on the etiology of respiratory failure.