Respiratory Failure Flashcards
What is respiratory failure
PaO2 <8kPa due to inadequate gas exchange
What is Type I resp failure
Hypoxia with normal or low CO2, caused by V/Q mismatch
Type I resp failure examples
Pneumonia
Pulmonary oedema
PE
Pulmonary fibrosis
Asthma
ARDS
Emphysema
What is Type II resp failure
Hypoxia with hypercapnia from alveolar hypoventilation
Type II resp failure causes
Pulmonary disease (asthma, COPD etc)
Reduced resp drive
Neuromuscular disease
Thoracic wall disease
Hypoxia clinical features
Dyspnoea Restlessness Agitation Confusion Central cyanosis
If longstanding, polycythaemia, pulmonary HT and cor pulmonale
Hypercapnia clinical features
Headache Peripheral vasodilation Tachycardia Bounding pulse Tremor/flap Papilloedema Confusion/drowsiness/coma
Type I resp failure management
Treat cause
Give 24-60% O2 by facemask
Assisted ventilation if PaO2 <8 despite 60% O2
Type II resp failure management
Treat cause
O2 therapy with care, start at 24%
Recheck ABG after 20 mins, if PaCO2 steady/lower, inc O2 to 28% but if PaCO2 rising then consider assisted ventilation
When to consider ABG
Unexpected deterioration in ill pt
Acute exarcebation of chronic chest condition
Impaired consciousness/ resp effort
CO2 retention signs
Cyanosis, confusion, visual hallucinations
Validate pulse oximetry measurements
Oxygen delivery methods
Nasal cannulae
Simple face mask
Venturi mask
Non-rebreathe mask
Nasal cannula usage
Preferred by pts
O2 delivery imprecise and can cause nasal soreness
Can be used to maintain sats when nebulisers need to be run using air
Simple face mask usage
Variable O2 depending on rate
Risk of CO2 accumulation within mask so inspired if flow rate <5L/min
Venturi mask usage
Precise FiO2 delivery
Non-rebreathing usage
Deliver high O2 concentrations
Imprecise O2 delivery
