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L21: Respiratory Failure Flashcards

1
Q

What is respiratory failure

A

The inability of the lung to meet the metabolic demands of the body. Failure of tissue oxygenation or carbon dioxide homeostasis

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2
Q

Clinically how is respiratory failure defined

A

Pao2 less than 8kpa
Or
Pac02 greater than 6.5kpa

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3
Q

What are the 3 elements that cause respiratory failure

A

Alveolar hyperventilation (mechanical)
Circulation failure
Alveolar tissue problem

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4
Q

What can a mechanical failure be due to

A

Central problem
Peripheral problem
Lung structure problem

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5
Q

What are the types of respiratory failure

A

Type 1

Type 2

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6
Q

What is type 1 respiratory failure

A

Pa02 less than 8kpa with normal/low paco2 this leads to normal/high ph

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7
Q

What is the problem in type 1 respiratory failure

A

Oxygen exchange occurring at the alveolar and pulmonary circulation

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8
Q

Is there a problem with mechanical ventilation in type 1 respiratory failure

A

No

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9
Q

What does a type 1 respiratory failure lead to

A

V/Q mismatch and shunt

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10
Q

What is type 2 respiratory failure

A

Hypoxic and Paco2 greater than 6.5kpa

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11
Q

What are the underlying causes of respiratory failure

A 
Sepsis
Pneumonia 
Pulmonary embolus 
COPD exacerbation 
Cardiogenic pulmonary edema
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12
Q

What are the symptoms of sepsis

A

Fever

Chills

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13
Q

What are the symptoms of pneumonia

A

Cough
Sputum production
Chest pain

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14
Q

What are the symptoms of pulmonary embolus

A

Sudden onset of shortness of breath

Chest pain

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15
Q

What are the symptoms of COPD exacerbation

A

Heave smoking
Cough
Sputum

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16
Q

What does hypotension (low blood pressure) suggest

A

Sepsis

Pulmonary embolus

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17
Q

What does hypertension (high blood pressure) suggest

A

Poor effusion : cardiogenic pulmonary edema

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18
Q

What does wheezing suggest

A

Airway obstruction

19
Q

How do we diagnose for respiratory failure

A 
Arterial blood gas
Blood
Cardiac markers
Microbiology 
Chest x-ray
ECG
Echocardiogram
Pulmonary function test 
CTPA
Ct scan
20
Q

What causes a patient with respiratory failure to die

21
Q

What is the primary objective to reverse respiratory failure

A

Reverse and prevent hypoxia

22
Q

After correcting the hypoxia in respiratory failure what is secondary objective to treat

A

Control paco2 and respiratory acidosis

23
Q

If a patient has rising paco2 what is required

A

Support to blow out co2

24
Q

How do we treat hypoxia

A

secure airway
Give supplemental oxygen
Treat underlying condition

25
Why is oxygen therapy used
Prevent tissue hypoxia and maintain normal oxygen
26
What is the most basic equipment to provide oxygen
Nasal cannula
27
What is nasal cannula
Tubes with two small prongs inserted into the nose
28
After nasal cannula what is used to supply oxygen
Simple face mask
29
What is the disadvantages of simple face masks
Rebreathing carbon dioxide
30
What is a non rebreather mask
A face mask attached to a bag
31
What does the bag in a non rebreather mask allow
Act as a reservoir for oxygen and allow more oxygen to be inspired at each breath
32
What are Venturi masks
Different sized adapters deliver different oxygen
33
When simple measures of proving oxygen failure what do we need to provide a patient
Mechanical ventilation
34
What does mechanical ventilation provide
The effort to breath
35
What are the 2 ways mechanical ventilation be carried out
Non invasive with a mask | Invasive with endobronchial tube attached to a machine
36
What is mechanical ventilation good to treat
Hypoxia | Hypercapnia
37
What is hypercapnia
High carbon dioxide
38
What does mechanical ventilation allow to rest
Respiratory muscles
39
When is mechanical ventilation used
``` Cardiac arrest Tachypnoae Acute respiratory acidosis Cardiogenic shock Brain injury ```
40
What pressure does mechanical ventilation provide
Positive pressure
41
Does invasive mechanical ventilation completely take over breathing
Yes
42
Why do we not want patients to reach negative pressure
The alveoli will collapse all the way down
43
Why is positive end expiratory pressure (PEEP) used in ventilation
Keeps the alveolus open and prevent them from collapsing Improve gas exchange Treat hypoxia Treat pulmonary edema

Irm (21 decks)

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