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Monica Respiratory > Oxygen and resp failure > Flashcards

Oxygen and resp failure Flashcards

1
Q

type 1 resp failure

A

short of oxygen

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2
Q

type 2 resp failure

A

short of oxygen

too much CO2

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3
Q

hypoventilation leads to _____ which leads to _____

A

hypoxaemia

hypercabia

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4
Q

if in doubt regarding type of resp failure what should be carried out

A

blood gas

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5
Q

primary hypoxia bad lungs

A 
low pO2/ high pCO2/ normal HCO3
acidosis
low pO2/ high pCO2/ high HCO3
virus
low pO2/ very high pCO2/ high HCO3
acidosis
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6
Q

anaesthetic opinion on giving O2

A 
hypoxia = bad
hypoxia = kills you
hypoxaemia = main cause of hypoxia
reverse all hypoxia
CO2 worry about later
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7
Q

chest physician opinion on giving O2

A

type 2 resp failure = very common
hypercarbia = damaging
O2 poisons
stop O2

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8
Q

oxygen in A + E

A

all O2

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9
Q

oxygen in AMU

A

controlled O2

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10
Q

oxygen in ICU

A

all O2 again

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11
Q

prescribing O2

A

O2 = drug

always ensure = prescribed

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12
Q

1st rule =

A

only give O2 if risk/ benefit ratio is in favour of O2

some people = very sensitive to O2

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13
Q

as pO2 rises =

A

pCO2 rises

  • acidosis
  • can be severe
  • can be life threatening
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14
Q

bad lungs =

A 
low pO2/ high pCO2/ normal HCO3
acidosis
low pO2/ high pCO2/ high HCO3
O2 given
high pO2/ very high pCO2/ high HCO3
acidosis
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15
Q

COPD patients T2RF

A

high risk of developing it

1/5 COPD patients

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16
Q

Areas of poor ventilation =

A

reactive vasoconstriction
excess O2 + reactive vasoconstriction = reserves
perfusion = good
ventilation = poor

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17
Q

effect of pCO2 on haemoglobin

A

haldane effect
-O2 can displace CO2 from Hb

bohr effect
-high concn of CO2 = prevent O2 binding to Hb

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18
Q

pCO2 Bohr Effect

A

shifts dissociation curve

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19
Q

Theory of Hypoxic Drive

A

normal respiration = driven by CO2 chemoreceptors
chronic hyperbia = destination of receptors
O2 chemoreceptors = primary respiration drive

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20
Q

Treat Hypercarbia

A 
Conservative O2 management 
SaO2 88-92%
increase Vminute
-RR = usually already high
-increase Vt with NIV
21
Q

Severe hypoxaemia

A 
Altered mental state
Cyanosis
Dyspnoea
tachypnoea
Arrhythmias
-tissue hypoxia

pO2<5.3kPa = hyperventilation increases dramatically

  1. 3kPa = loss of consciousness
  2. 7kPa = death
22
Q

circulatory hypoxia

A

O2 blood needs to get to tisses

23
Q

global reduction - circulatory hypoxia

A

heart failure

24
Q

local reduction - circulatory hypoxia

A

obstruction of vessels
oedema
compression
compartment syndrome

25
Q

types of hypoxia

A

circulatory hypoxia
anaemic hypoxia
toxic hypoxia
hypoxaemic hypoxia

26
Q

hypoxaemic hypoxia

A

low inspired O2 concn

27
Q

impaired diffusion

A

failure of alveolar - endothelial surfaces

28
Q

interstitial thicking

A

pulmonary fibrosis
lymphangitis
sarcoidosis

29
Q

vascular dysfuction

A

pulmonary vasculitis

endothelial malignancy

30
Q

what is required for transfer of O2 from airway to blood

A

adequate perfusion

adequate ventilation

31
Q

perfusion without ventilation

A

shunting

32
Q

ventilation without perfusion

A

dead space

33
Q

lung apex

A

good v

poor Q

34
Q

lung base

A

poor V

good Q

35
Q

where should perfusion be directed

A

areas of best ventilation

36
Q

steps patient = hypoxia

A 
which bit = failing
cardiac output
haemoglobin
poisoning
then lungs
37
Q

patient = hypoxaemia

A 
O2 given (not for breathlessness)
reversal hypoxaemia = not always beneficial
high flow/ concn O2 = rarely beneficial
38
Q

high flow, high concn O2 therapy used for

A

cluster headaches
CO poisoning
pneumothorax - no chest drain
sickle cell crisis

39
Q

If SaO2 greater than or equal to 90%

A

no O2

40
Q

COPD SaO2

A

88-92%

41
Q

90-94%

A

everything bar COPD

42
Q

Vmin =

A

Vt x RR

43
Q

Vmin @ rest

A

5-40l

44
Q

Vmin when unwell

A

400l

45
Q

nasal cannulae

A

well tolerated
low flow only
uncontrolled FiO2
Nasal breathing dependent

46
Q

variable performance mask

A

cheap and simple
5-15l/min
uncontrolled fiO2
unable to cope with high flow requirements

47
Q

venturi mask

A

fixed performance

flows of up to 250 l/min

48
Q

non-rebreathing mask

A 
up to 85% FiO2
uncontrolled fiO2
flow limited to outflow of wall
beware large Vt
Indications for mask = now very few (CO poisoning, PTX, cluster headaches, sickling crisis)

Monica Respiratory (21 decks)

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