chronic ventilator failure Flashcards
1
Q
what are the features of chronic ventilatory failure
A
elevated pCO2 (>6.0kPA)
pO2 < 8kPA
Normal blood pH
elevated bicarbonate (HCO3-)
2
Q
what arw the causes of chronic ventilatory faikure
A
airways disease
- COPD
- bronxhiectasis
chest wall abnormalities
- kyphoscoluosus
respiratory muscle weekness
- motor nehrons disease (ALS)
- muscular dystrophy
- glycogen storafe disease (pompes dosease)
central hypocentilation
- onesity hypovent sybdrome
- convenital central hypoventilation syndrome
3
Q
what are the typicak symtoma of chronic vent failyre
A
brethlessness orthopnoea - breathless lying fkat ankle swelling morning headache recurrent chest infections distrurbed sleep
4
Q
what are examination findings if chronic ventikatory disease
A
reflects underlyting disease particukarly look for paradoxual abdominal wall morion in suspected neuromuscukar disease ankle ordma (hypoxic cor pilmonale)
5
Q
what investigations would we do
A
lung functions
- lying and standing VC
- mouth lressures/ SNIP
assessment of hypovwnt
- early morning ABG
- overnight oximtery
- transcutaneous CO2 monitoring
fluoroscopuc screening of diaphragms
6
Q
what would the pulmonary fucntion test be for someone w chrinic resp faikure
A
FEV1 - 1.05
FVC - 1.2
87% ratio - hugh which is characteristic of resteictive
7
Q
how do you trest it
A
fonicillaty non invasive ventilation (NIV)
oxygen theraot
(t-IPPV)
