Respiratory Failure And Intubation

Question 1

Define chronic respiratory failure

Answer 1

Failure to maintain adequate ventilation for oxygen delivery or CO2 removal. Long term changes in ABG results with metabolic compensation

Question 2

Define hypoxaemic respiratory failure

Answer 2

PaO2

Question 3

Define hypercapnic respiratory failure

Answer 3

PaCO2 >50mmHg

Inadequate ventilation (pump)

Question 4

List the causes and mechanisms of respiratory failure

Answer 4

Hypoxaemic - no gas to perfused areas (lobar collapse), limited gas to perfused areas (decreased FRC), impairment of gas exchange (pulmonary fibrosis)

Hypercapnic - decreased drive to breathe (opiate overdose), impaired neuromuscular function (Guillain Barre syndrome, Cx SCI, weak or fatigued respiratory muscles), increased WOB (increased airway resistance or decreased compliance of lung or chest wall)

Question 5

List the reasons why a patient may need to be intubated

Answer 5

Protect lower airway
Maintain upper airway patency
Allow for ventilation
Allow for suctioning

Question 6

Describe the clinical manifestations of acute respiratory failure

Answer 6

PaO2 drop or PaCO2 rise
Decreased PaO2 - decreased mental acuity, increased RR, dyspnoea,
Changed POB
Increased PaCO2 - drowsy, confused, falls, increased RR, increased ICP, cerebral vasodilation, changed POB, changed consciousness

Question 7

Describe the reasons for tracheostomy

Answer 7

For long term MV
Prevent vocal cord damage
Facilitate weaning - Reduce WOB
Improved communication

Question 8

Define acute respiratory failure

Answer 8

Failure to maintain adequate ventilation for oxygen delivery or CO2 removal.
Rapid onset
Pronounced symptoms
Short duration?