Respiratory distress Flashcards
What are 8 features of moderate respiratory distress?
- Tachypnoea >50 bpm
- Tachycardia
- Nasal flaring
- Use of accessory respiratory muscles
- Intercostal and subcostal recession
- Head retraction
- Grunting
- Inability to feed
What are 5 signs of severe respiratory distress?
- Cyanosis
- Tiring because of increased work of breathing
- Reduced conscious level
- Oxygen saturation <92% despite oxygen therapy
- Rising partial presure of carbon dioxide (pCO2)
Why are children and especially infants particularly susceptible to respiratory failure?
they have compliant chest walls and poorly developed respiratory muscles
What might cause the signs of respiratory distress to become less marked?
When children become exhausted
What is a definition of respiratory failure?
failure of the lungs to maintain adequate gas exchange
What are 4 pathophysiological causes of respiratory failure i.e. failure of lungs to maintain adequate gas exchange?
- Alveolar hypoventilation
- Diffusion impairment
- Intrapulmonary shunting
- Ventilation-perfusion mismatch
What are the 3 life-threatening complications of respiratory failure?
- Hypoxaemia - can lead to tissue hypoxia
- Hypercarbia - can lead to carbon dioxide narcosis
- Exhaustion - respiratory arrest
What does the assessment of respiratory failure involve?
ABC approach - emphasis on work of breathing and effects of hypoxaemia on other organ systems, especially heart and brain
What are the steps of management of respiratory failure?
from oxygen via nasal cannulae, to noninvasive ventilation, to invasive ventilatory support: ET tube, mechanical ventilation
When shouhld children be given oxygen therapy?
if peripheral capillary oxygen saturation (SpO2) is less than 92
How can delivery of oxygen be achieved and what is it based on?
- face mask or nasal cannula
- maximum fractional concentration of inspired oxygen (FiO2) that can be delivered via facemask is 60% unless reservoir bag added
- titrated according to pulse oximetry
What are the 3 things that noninvasive ventilation encompasses?
- Continuous positive airway pressure (CPAP)
- Biphasic positive airways pressure (BiPAP)
- More recently: high-flow nasal cannula therapy
What are 2 ways that CPAP and BiPAP can be delivered?
via face mask or nasal mask
What does high flow nasal cannula therapy involve?
delivers high-flow humidified gas whilst providing some CPAP with a known oxygen concentration
What does invasive ventilatory support involve?
endotracheal intubation and mechanical ventilation
