Respiratory Failure Flashcards
ARDS
Neutrophilic inflammation
Fluid accumulates
Can’t remove edema
Reduced surfactant
Phases of ARDS
Exudative
Fibroprilerative phase - Pulm HTN
Recorvery phase
Causes of hypoxemia/hypercapnea
Low PP of inhaled O2 Alveolar hypoventilation Diffusion impairment R-L shunt (V/Q = INfinity) VQ mismatch
V/Q = 0
vs.
V/Q = infinity
0 - alveoli equilibrates with venous blood…think atelectasis…lower O2
Infinity - alveoli equilibrates with atmosphere…think PE…higher O2
Regional V/Q
V/Q higher at the top vs. the bottom
INcreasing RR
Would fix if diffuse alveolar hypoventilation
Changes made will only affect the good lung
Vasodilator effects
Lung already attempts to divert blood by selective vasoconstriction
Transusing blood
No impact on hypoxemia
CO poisoning
All burns/explosions
Common in house fires
High CO affinuty for Hb
will bind 1 of 4 sites and become carboxyHb
Increase O2 affinty at 3 reminaing sites
Shifts cruve to the left
Cherry-red lips
Alveolar ventilation
(TV-dead)*RR
Normally the dead is about 150 mL
Do the math to figure out best option
Endocarditis
Fevers, IV drug use, cardiac murumr, spinter hemorrhages
Think about septic emboli to lungs causing pneumonia and ARDS
If pt pregnant
Low chest wall and lung compliance
WHat to look for in venous return compromise
Hypotenson and hypoxia
Poorly compliant lungs
Elevated airwya pressures
Decreased breath sonds
JVP
INcreased intreathoracic pressure differential
Excessive ventilatory pressures can reduce
More commonly seen in excessive ventilation without sufficient time to exhale…this can lead to air trappign and over distension of the lungs…common cause of cardiac arrest following intubation for COPD/asthma
Can lead to pneumothorax
Cardiac tamponade diff
Low arterial pressure
Distended neck veins
Muffled heart sounds
