Resp Failure Flashcards
WHat is Respiratory Failure?
Lungs fail to adequately oxygenate arterial blood and/or Prevent retension of CO2
Consequence of underlying conditions
WHat is Acute Respiratory Failure?
Abrupt onset with rapid progression
Sometimes reversible
WHat is Chronic Respiratory Failure?
Slow onset and progression
irreversible
What is Acute on ChronicRespiratory Failure?
increased baseline O2 requirements
Increase CO2 above baseline enough to drop pH
What are ventilation causes of Acute Resp Failure?
Drug overdose
What are oxygenation causes of Acute Resp Failure?
Pneumonia
What are ventilation causes of Chronic Resp Failure?
Neuromuscular Disease
What are oxygenation causes of Chronic Resp Failure?
Pulmonary Fibrosis
WHat are the types of Respiratory Failure?
Hypoxemic Resp Failure
Hypercapnic Resp failure###
What are the causes of Hypoxemia?
Host -Hypoventilation -Diffusion impairment -Shunt -V/Q mismatch Environment -Low FiO2
What are the clinical Manifestations of Tissue Hypoxia?
Resp -Cyanosis -Tachypnea CV -Tachycardia -Hypertension CNS -Confusion Lactic Acidosis Low SpO2 Other Organ Failure
What are common conditions that Can lead to Resp Failure?
Cardiac Dysfunction Pulm infection or Aspiration Venous Thromboembolus Obstructive Lung disease Pleural Disease -Pneumothorax -Effusion Chest Trauma -contusion -hemothorax
What is the P/F Ratio
Ratio of Oxygen delivery to Arterial Oxygen
What is done to give initial support to a Pt in Resp Failure?
Supplemental O2 IV Acess Vital Sign monitoring -SpO2 -HR -BP -EKG
What drugs are given to Support someone in resp failure?
Chronotropes
Ionotropes
Arrhythmia Control
Vasodilators in CHF
What are the goals in Advanced support in Resp Failure?
Hb Conc > 7 COutput -IVF 30ml/kg -Vasopressors Goal Lactic Acid
WHat are the affects of CO2 on pH?
Acute rise of 10 = dec pH by 0.08
Acute drop of 10 = raise pH by 0.08
Chronic rise of 10 = dec pH by 0.03
Chronic drop of 10 = Raise pH by 0.03
What are the effects of CO2 changes on Bicarb concetrations?
Acute Resp Acidosis: CO2 +10 = Bicarb +1
Chronic Resp Acidosis: CO2 +10 = Bicarb +3
Acute Resp Alkalosis: CO2 -10 = Bicarb -2
Chronic Resp Alkalosis: CO2 -10 = Bicarb -5
What is the treatment of Chronic Respiratory Failure?
Smoking cessation Vaccination Oxygen therapy Mech Ventilation Supportive Care and ED Nutrition (wt loss/gain) Pulm Rehab Transplantation Palliation
What are the vaccines that COPD patients need to recieve?
Pertussis
Influenza
Pneumococcal
What are the effects of oxygen therapy in COPD?
Improves survival, dyspnia, and Exercise Tolerance
No improvement in Lung function, or survival in Pts with Moderate or nocturnal Hypoxemia
What qualifies someone for Oxygen therapy?
PaO2
What are the Absolute Contraindications for Lung Transplant?
Absolute: Major organ dysfunction HIV Hep C/B Active Malignancy Substance abuse Non-osteoporotic musculoskeltal disease
What are the Relative Contraindications for Lung Transplant?
Systemic or Multisystem dz Active infection Resistant microorganisms Osteoporosis Mech Ventilation BMI >30 Steroids
WHat are signs of Chronic Respiratory failure?
Polycythemia Elevated CO2 Nomral pH w/ elevated PaCO2 Elevated Bicarb Clubbing
What are adverse effects of O2 administration in someone with Respiratory failure?
Hypercapnia 2/2
increased physiologic dead space from V/Q mismatch
Attenuated hypoxic ventilatory drive
Haldane effect
What is the Haldane effect?
Deoxygenation of the blood increases its ability to carry carbon dioxide.
Conversely, oxygenated blood has a reduced capacity for carbon dioxide.
What are the causes of Hypercapnia?
(Increased CO2) Hypoventilation(drive) Neuromuscular Body Habitus Drugs Increased Production -Sepsis, fever, burns, trauma, seizures Airway obstruction Resp muscles V/Q mismatch
