RADS Flashcards

1
Q

RADS type I

A

hypoxemic; PaO2<60

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2
Q

RADS type II

A

hypercapnic and hypoxemic; PaCO2 > 45

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3
Q

Acute decrease in PaO2

A

increase in a catecholamine surge leading to increase heart rate - carotid body senses it and it leads to increase in resp. rate and ventilation

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4
Q

Acute increase in PaCO2

A
  • decrease in pH and increase in intracranial pressure leading to CO2 narcosis, headache
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5
Q

most common mechanism for hypoxemic RADS

A
  • shunt - V/Q
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6
Q

causes of chronic hypoxemic RADS

A
  • V/Q mismatch: COPD, ILD, Pulm htn - shunt: pulm arteriovenous malformation, hepatopulm. syndrome
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7
Q

hypercapnic RADS

A
  • increase in dead space - increase work of breathing - decrease in resp. drive and pump
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8
Q

causes of acute hypercapnic- hypoxemic RADS

A
  • hypoventilation: drug overdose, acute spinal cord injury, acute neuromuscular dx. - v/q. increase in dead space, load and muscle fatigue: COPD, status asthmaticus
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9
Q

causes of chronic hypercapnic RADS

A

chronic Neuromuscular dx., thoracic cage, OHS

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10
Q

what is an issue with the nasal cannula?

A

variable FiO2

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11
Q

tell me about the standard face mask?

A

high flow O2 but FiO2 is still variable

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12
Q

HFNC

A

there is improved oxygenation, clearing of anatomic dead space and improved secretion clearance

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13
Q

complications of O2 therapy how should we try to prevent them?

A
  • reactive O2 species are cytotoxic - peds: blindness and bronchopulmonary dysplasia - absorptive atelectasis use lowest FiO2 to maintain desired PaO2, SaO2
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14
Q

what is mechanical ventilation?

A

supportive therapy where there can be a reverse but recovery depends upon reversal of underlying disease process - can be either full or partial support

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15
Q

PEEP

A

positive end-expiratory pressure - increase lung volume, decrease in atelectasis

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16
Q

complication of mechanical ventilation

A
  • can lead to over-distension of lung - intubation may be required - ventilator associated pneumonia
17
Q

advantage of non-invasive ventilation? disadvantage?

A

advantages: less sedation, decreases chances of pneumonia disadvantages: hard to tolerate mask

18
Q

inflammatory injury to alveoli leading to increase permeability of alveolar-capillary barrier

19
Q

all what must be present in ARDS

A
  • acute onset - abnormal CT - respiratory failure - hypoxemia
20
Q

what are some commone causes of ARDS

A
  • direct: pneumonia, inhalation, pulm. contusion - extrapulmonary: sepsis, pancreatitis, drugs
21
Q

acute lung injury leads to

A

increased permeability

22
Q

abnormal surfactant

A

decreased compliance with alveolar collapse anda flodding

23
Q

main cause of neonataal resp. distress syndrome

A

surfactant deficiency

24
Q

ARDS network trial showed

A

lower tidal volumes protect the lung

25
ventilator-induced lung injury
- volutrauma - barotrauma - biotrauma - atelectrauma
26
repetitive opening and closing of alveoli can injury alveoli
atelectrauma
27
injury to lung releases harmful cytokines --\> further lung injury and injury to other organs
biotrauma
28
injury to lung indistinguishable from ARDS
volutrauma
29
rupture of alveoli with gas escaping into pleural space (pneumothorax)
barotrauma
30
ARDS showing dense lower lobe atelectasis- alveoli in these areas are gasless
31
minute ventilation is
respiratory rate X volume
32
concentration of O2 equation
HbxSaO2 + .003xPaO2
33
is nasal cannula associated with CO2 rebreathing
nope
34
whne do you need to humidify air whne delivered through a device
at high flows
35
absorption atelectasis
happens when an obstructed alveoli is given Pure O2 washing out nitrogen and the partial pressure decreases. Alveoli collapses
36
non-ivasive mechanical ventilation works very well for
COPD exarcebation
37
ARDS cut off of symptoms
a week
38
alveolar ventilation mechanism
increase perfusion and thus imrpving oxygention but not mortality
39
lack of effectiveness of surfactant in adult ARDS
there are inhibtors that blcok surfactant