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Z Year3 Resp Conditions > Respiratory failure > Flashcards

Respiratory failure Flashcards

1
Q

What is respiratory failure?

A

acute or chronic impairment of gas exchange between lungs and blood causing hypoxia with or without hypercapnia
PaO2 <8kPA

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2
Q

What are RF for resp failure?

A
  1. Tobacco use
  2. Young age
  3. Old age
  4. Resp system illness
  5. Injury or infection
  6. Cardiac failure
  7. Hypercoaguable states
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3
Q

What is T1 resp failure?

A

hypoxia with normal or low PaCO2

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4
Q

What is T1 resp failure caused by?

A
  1. ventilation/perfusion mismatch
  2. hypoventilation
  3. abnormal diffusion
  4. right to left cardiac shunts
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5
Q

What are examples of V/Q mismatch?

A
  1. Pneumonia
  2. Pulmonary oedema
  3. PE
  4. Asthma
  5. Emphysema
  6. Pulmonary fibrosis
  7. ARDS
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6
Q

What is T2 resp failure?

A

hypoxia with hypercapnia (PaCO2>6kPA)

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7
Q

What is T2 resp failure caused by?

A

alveolar hyperventilation with or without V/Q mismatch

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8
Q

What are 4 key causes of T2 resp failure?

A
  1. Pulmonary disease
  2. Reduced resp drive
  3. Neuromuscular disease
  4. Thoracic wall disease
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9
Q

What pulmonary disease causes T2 resp failure?

A
  1. asthma
  2. COPD
  3. pneumonia
  4. end-stage pulmonary fibrosis
  5. OSA
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10
Q

What causes reduced resp drive?

A
  1. sedative drug

2. CNS tumour or trauma

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11
Q

What neuromuscular disease causes T2 resp failure?

A
  1. cervical cord lesion
  2. diaphragmatic paralysis
  3. poliomyelitis
  4. myasthenia gravis
  5. GB syndrome
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12
Q

What thoracic wall disease can cause T2 resp failure?

A
  1. flail chest

2. kyphoscolisosis

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13
Q

What are signs and symptoms of hypoxia?

A
  1. Dyspnoea
  2. Restlessness
  3. Agitation
  4. Confusion
  5. Central cyanosis
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14
Q

What could long standing hypoxia cause?

A
  1. polycythaemia
  2. pulmonary hypertension
  3. cor pulmonale
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15
Q

What are signs of hypercapnia?

A
  1. Headache
  2. Peripheral vasodilation
  3. Tachycardia
  4. Bounding pulse
  5. Tremor/flap
  6. Papilledema
  7. Confusion
  8. Drowsiness
  9. Coma
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16
Q

What are possible DDx for resp failure?

A
  1. Hyperventilation secondary to metabolic acidosis
  2. Hyperventilation secondary to anxiety
  3. Sleep apnoea
  4. Obesity
17
Q

What bloods are done for resp failure?

A
  1. FBC
  2. U+Es
  3. CRP
  4. ABG
18
Q

What other investigations are done for resp failure?

A
  1. CXR
  2. Microbiology sputum and blood cultures (if febrile)
  3. Spirometry: COPD, neuromsuclar disease, GB syndrome
  4. ABG
  5. Pulse OX
19
Q

What is the management for T1 resp failure?

A
  1. Treat underlying cause
  2. Give oxygen (24-60%) facemask
  3. Assisted ventilation if PaO2<8KPa despite 60% O2
20
Q

How is the resp centre affected in T2 resp failure?

A

may be relatively insensitive to CO2 and respiration may be driven by hypoxia

21
Q

What is the management of T2 resp failure?

A
  1. Treat underlying cause
  2. Controlled oxygen therapy: start 24%
  3. Recheck ABG after 20min – if PaCO2 raised >1.5KPA and patient still hypoxic consider assisted ventilation: NIV
  4. Consider intubation and ventilation
22
Q

What are possible complications of resp failure?

A
  1. Pneumothorax
  2. Endotracheal tube misplacement or dislodgement ]
  3. Dental injury with intubation
  4. Infection from CPAPA or BIPAP

Z Year3 Resp Conditions (20 decks)

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