Pulmonary Critical Care Flashcards
How is respiratory failure defined?
Occurs when lungs fail to oxygenate the arterial blood accurately and/or fail to prevent CO2 retention
What is type I respiratory failure?
Hypoventilation
What is minute ventilation?
Can lead to both low PAO2 and high PCO2 d/t decreased total volume of inhaled/exhaled air per minute
What is the average minute ventilation for an adult?
8 L/min
What are the causes of hypoxemia due to low FIO2?
High altitude
Smoke inhalation
Hypoventilation (CNS depression)
COPD
How can you assess oxygenation?
- Assessed by the PaO2
- Arterial blood gas analysis
- Estimated oxygen status with pulse oximetry
- A-a gradient
- PF ratio
- CXR
How is PF ratio measured?
PaO2/FiO2
When is PF ratio used?
Value used in definition of ARDS
What is a normal PF ratio?
> 400
Where are the respiratory center located?
Medulla Oblongata
For every Liter of oxygen added how much are you increasing the patient’s FiO2?
3-4% per L
What are some direct pulmonary causes of ARDS?
- Chest trauma/lung contusion
- Acid suppression
- pneumonia
What are the clinical manifestations of ARDS?
- Significant respiratory distress
- Dyspnea
- Tachypnea
- Hallmark is hypoxia despite significant FiO2
What is a typical way to describe a CXR in a patient with ARDS?
Complete whiteout
What is essential in managing ARDS?
Identify/treat underlying or predisposing cause of ARDS (Golden Hour mentality- abx or other treatment ASAP)
What is a critical ventilator management for ARDS?
Lung Protection Strategy to prevent barotrauma
The two main aspects of protective mechanical ventilation are to limit tidal volume (VT) and plateau pressures to prevent lung damage caused by overdistension and to set PEEP level to minimize the cyclic opening and closing of airways and lung units
An increased PEEP can have what effect on intracranial pressure?
Increased ICP
What is the most common symptom in foreign airway obstruction?
Cough
