Lecture 14 - Respiratory Failure Flashcards
1
Q
Consequence of CO2 buildup?
A
- Acidosis
2
Q
Signs of CO2 buildup?
A
- Sleepiness
- Headache
- Confusion
- Coma
3
Q
How do we breathe in and out?
A
- Positive pressure in atmosphere
- Negative pressure in airways
- Air drawn into lungs
- Conducting airways
- Gas exchange
4
Q
What is Boyle’s Law?
A
5
Q
What comprises the conducting zone?
A
- Nose
- Pharynx
- Larynx
- Trachea
- Bronchi (primary, secondary, tertiary)
- Bronchioles
- Terminal Bronchioles
6
Q
What comprises the respiratory zone?
A
- Respiratory Bronchioles
- Alveolar ducts
- Alveoli
7
Q
What is Type 1 Respiratory Failure?
A
- Hypoxia
- CO2 levels normal
8
Q
What is Type 2 Respiratory Failure?
A
- “Ventilatory Failure”
- Hypercapnia
- Hypoxia
- Tends to be chronic
9
Q
What can cause Type 2 Respiratory Failure?
(x10)
A
- Guillain Barre Syndrome (Acute)
- Botulism (Acute)
- Muscular Dystrophy (Chronic)
- Motor Neurone Disease (Chronic)
- Brain tumour
- Stroke
- Kyphoscoliosis
- Obesity
- Thoracoplasty
- Spinal cord tumour
10
Q
What is negative pressure ventilation?
A
- Creation of a negative or subatmospheric pressure within a rigid box which draws air into the the lungs.
- When you remove negative pressure, exhalation occurs.
- “Iron Lung”
11
Q
What is Positive Pressure Ventilation?
A
- Ventilator pushes air into the chest under positive pressure
- Positive pressure inflates lung
- Delivered via endotracheal tube
- “IPPV - Invasive + pressure ventilation)
12
Q
What is Positive End Expiratory Pressure?
A
- When on positive pressure ventilation, expiration pressure isn’t quite 0.
- Work of breathing is hardest at beginning (ie. initial inflation of alveoli)
- So you keep a bit of positive pressure during expiration in order to avoid that initial inflation pressure.
13
Q
What are the problems with positive pressure ventilation?
A
- Barotrauma / PTX
- Positive pressure over-distends and shears the alveoli
- Shearing alveoli causes cytokine release
- Hypotension / reduced cardiac output (+ pressure squeezes vessels returning blood to heart)
- Ventilator associated pneumonia
14
Q
What is non-invasive ventilation? (NIV)
A
- Face mask strapped on which shoves + pressure in.
- Rather than invasive tube
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15
Q
Case 1
A
