Physiology of Respiratory Failure Flashcards
What is type 1 respiratory failure?
Hypoxic respiratory failure
What is type 2 respiratory failure?
Hypercapnic respiratory failure
What does lung failure lead to?
Type 1 respiratory failure
What does pump (heart?) failure lead to?
Type 2 respiratory failure
What is the problem in type 1 respiratory failure?
Gas exchange
What is the problem in type 2 respiratory failure?
Ventilation
What is the definition of hypoxaemia?
PaO2 < 8kPa
What are the 5 causes of hypoxaemia?
1) VQ mismatch (main reasons)
2) Alveolar hypoventilation e.g. GBS (neuromuscular diseases)
3) Impaired diffusion e.g. pulmonary fibrosis (can’t get gas across BM)
4) Low partial pressure of inspired oxygen (low PiO2) e.g. flying
5) Anatomical R-L shunt e.g. PAVM lobar pneumonia
What is the most common cause of arterial hypoxaemia?
VQ mismatch
Describe V/Q matching
- Ventilation and perfusion must be exactly matched
- Va = Q
- Va/Q is the critical factor governing gas exchange
- Regions of high ventilation should have high blood flows i.e. base of lung
- Regions of low ventilation should have low blood flows i.e. apex of lung
What does inadequate gas exchange occur?
When regional Va «_space;1 or Va/Q»_space; 1
What happens in shunt?
- Va/Q = 0
- Q»_space; Va
- There is wasted perfusion so the blood is perfusing an underventilated lung
- So low PAO2 (40) and high PACO2 (46)
What happens in dead space?
- Va/Q = infinity
- Q «_space;Va
- There is wasted ventilation as we are ventilating and underperfused lung
- So PAO2 = 150 (v high) and PACO2 = 0
What happens in an ideal VA/Q match?
- Va/Q = 1
- Q = Va
- PAO2 = 100 and PACO2 = 40
What happens to blood flow in a healthy lung?
There are important reflex mechanisms that increase blood flow to well ventilated alveoli and reduce blood flow to poorly ventilated alveoli