mod 6: Resp failure Flashcards
hypoxemic
o2<50, decreased diffusion to capillary
Hypercapnic
co2>50, decreased alveolar ventilation
seen w resp center depression (disorders of medulla or neuromusc junction etc)
spontaneous pneumothorax
tall thin males, d/t emphysemic bleb rupture in apices anytime, air in pleural space
Secondary pneumothorax
tension pneumothorax
d/t trauma, air trapped in thoracic cavity
site of injury=one way valve
deviated trachea, hypotension, hyperresonance to percussion
Pulm edema
water in alveoli- orthopnea, cp, hypoxia nocturnal dyspnea
L side heart failure d/t ^pulm hydrostatic pressure pushing fluid out
ards/gases=damaged alveolar capillaries lets water in
post obstructive pulm edema
inspiration against an occluded airway=high thoracic negative pressure= ^R side venous return/vOutflow L side
=^pulm volume/pressure
pulm edema s.s
rales, dullness to percussion, s3, frothy sputum
acute resp distress syndrome caused by
^ risk(7)
d/t lung inflammation/damaged alveolar capillaries=pulm edema, poor gas exchange, hypoxemia
pna, sepsis, trauma, aspiration, burn, pancreatitis, DIC ^risk
ARDS xray
bilateral lung infiltrates w no HF, FVO, low o2/inhaled o2 ratio
ards inflammation d/t
sepsis, trauma, blood transfusions
ards
1.inflammatory stage
72hrs
inflammation cascade triggered injuring capillary(^perm)
vGas exchange, compliance, alv ventilation, surfactant
^Work of breathing
hypercapnea
ards
2.proliferative
1-3wks
pulm edema resolves
surfactant produced again
intra alveolar exudate->granulation tissue=hypoxemia worsens
ards
3.fibrotic
14-21 days (overlap w phase 2)
alveolar fibrosis permanent impaired function
vFunctional residual capacity, vq mismatch, R-Lshunting
pulm htn
ARDS s/s
poor response to O2, resp alkalosis, met acidosis
vTidal volume, organ dysfunction , vCO, hypotension
ards classification
pF ratio
mild: 201-300
moderate: 101-200
severe: <100
