Anaesthetics critical care Flashcards
define type 1 respiratory failure
oxygenation failure
define type 2 respiratory failure
oxygenation and ventilation failure (increased pco2)
what level should o2 sats be above
88%
how is type 2 treated?
titrate o2 up
what is noninvasive ventilation
CPAP continuous positive airway pressure – improves oxygenation both via CPAP plus closed system. Assisted spontaneous ventilation = augmentation of intrinsic respiratory effort this improves minute volume and increases CO2 clearance.
what is invasive ventilation
Endotracheal tube - Allow use of higher pressure without leakage, Airway protection, Full ventilation overriding or not dependant on intrinsic effort
when is ventilatory support needed?
severe pneumonia, PE, CCF, bronchospasm if it is life threatenings, SIRS
What Cardiovascular support is given?
fluid resuscitation, inotropic or vasoactive support, intra-aortic balloon counter pulsation, extracorporeal support e.g. AV, ECMO, VAD
What Renal support?
Continuous veno-venous hemofiltration, Usually secondary rather than primary – e.g. acute renal failure secondary to sepsis or other shock states
what hepatic support?
MARS = molecular adsorbents recirculating system, Long term, transplant is the only option, Only done at specialist treatment centres, Supportive management of acute decompensation of chronic failure
what neurological support?
Airway protection, Monitoring of ICP bolts and continuous EEG,
Treatment of ICP: Management of physiological parameters, Osmotherapy, mannitol, hypertonic saline, Therapeutic hypothermia
Trauma, spontaneous intracranial haemorrhage, status epilepticus, meningitis
define Distributive (septic) shock…
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define Hypovolaemic shock…
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define Anaphhylactic shock…
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define Neurogenic shock…
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