Respiratory Failure

Question 1

Define respiratory failure

Answer 1

A syndrome of inadequate gas exchange due to dysfunction of one or more components of the respiratory system

Question 2

What is the main clinical feature of respiratory failure

Answer 2

Shortness of breath

Question 3

What are the 3 main systems affected in respiratory failure?

Answer 3

Respiratory
Nervous
Pulmonary

Question 4

Where in the world is respiratory failure most common

Answer 4

North America and north Europe

Question 5

How does the epidemiology of respiratory failure differ between men and women?

Answer 5

Biggest risk factor for men is smoking

Biggest risk factor for women is household air pollution

Question 6

What is the acute outcome of respiratory failure?

Answer 6

Respiratory distress syndrome

Question 7

What causes increased risk of mortality in ARDS?

Answer 7

With age and severity

Question 8

What are some causes of acute respiratory distress?

Answer 8

Pulmonary causes eg infection, graft dysfunction, aspiration

Question 9

What are some causes of chronic respiratory distress?

Answer 9

Pulmonary causes eg COPD, lung fibrosis, lobectomy

Musculoskeletal causes eg muscular dystrophy

Question 10

What are some causes of acute on chronic respiratory distress?

Answer 10

Infective exacerbation eg in COPD and CF
Myasthenic crisis
Post operative

Question 11

What is type 1 respiratory failure known as

Answer 11

Hypoxemic respiratory failure

Question 12

What are some common causes of type 1 respiratory failure?

Answer 12

Collapse, aspiration, pulmonary oedema, fibrosis, pulmonary embolism, pulmonary hypertension

Question 13

What is pO2 in type 1 respiratory failure?

Answer 13

< 60

Question 14

What is type 2 respiratory failure known as?

Answer 14

Hypercapnic respiratory failure

Question 15

What are some causes of type 2 respiratory failure?

Answer 15

Neuromuscular disorders, nervous system disorders, airway obstruction, chest wall deformity

Question 16

What is pCO2 in type 2 respiratory failure?

Answer 16

> 45

Question 17

What is the issue in type 2 respiratory failure?

Answer 17

Failure to exchange or remove carbon dioxide

Question 18

What is the issue in type 1 respiratory failure?

Answer 18

Failure of oxygen exchange

Question 19

What is type 3 respiratory failure known as?

Answer 19

Perioperative respiratory failure

Question 20

What is the issue in type 3 respiratory failure?

Answer 20

Hypoxemia or hypercapnia

Question 21

What causes type 3 respiratory failure?

Answer 21

Low functional residual capacity and abnormal wall mechanics

Question 22

How is type 3 respiratory failure prevented?

Answer 22

Anaesthesia, analgesics, correct posture during surgery, attempts at lowering intra abdominal pressure

Question 23

What is type 4 respiratory failure known as?

Answer 23

Shock

Question 24

What are some types of shock?

Answer 24

Neurologic, cardiogenic, spetic

Question 25

How does positive pressure ventilation affect the left ventricle?

Answer 25

In a good way as there is reduced afterload

Question 26

How does positive pressure ventilation affect the right ventricle?

Answer 26

In a bad way as there is increased preload

Question 27

What are some risk factors for chronic respiratory failure?

Answer 27

COPD
Pollution
Recurrent pneumonia 
CF
Pulmonary fibrosis
Neuromuscular disease

Question 28

What are some risk factors for acute respiratory failure?

Answer 28

Infection
Aspiration
Trauma 
Pancreatitis
Transfusion

Question 29

Describe how acute lung injury occurs in ARDS and how it leads to inefficient gas exchange

Answer 29

Injury causes damage to the interstitium
Alveolar macrophages are activated
Cytokines are released eg IL6, IL8, TNF alpha
Alveolar fluid builds up=oedema
Lung is less efficient at expanding
Damage to the vessels means neutrophils etc leak out into the intertsitium
There is an increased gap between the vessel and alveoli leading to reduced gas exchange