Respiratory Failure/Respiratory Arrest Flashcards

1
Q

ards

A

denotes acute hypoxemic respiratory failure following a systemic or pulmonary. insult w/o evidence of heart failure

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2
Q

what is the FI o2 ratio in ards?

A

<200

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3
Q

what are the main causes of ards

A

sepsis syndrome, severe muliple trauma, and aspiration of gastric contents

(others- shock, toxic inhalation, near-drowning, multiple transfusions)

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4
Q

RF of ards

A

sepsis, aspriation of gastric contents, shock infxn, lung contusion, non-thoracic trauma, toxic inhalation,

1/3 of ards pts have sepsis syndrome

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5
Q

ards pathogenesis

A

increases permeability of the alveolar capillary membranes, which leads to the development of protein-rich edema

pro-inflammatry cytokines released from stimulated inflammatory cells-pivotal in lung injury ** damage to capillary endothelial cells and alveolar epithelial cells is common to ARDS regardless of cuas–> interstitial and alveolar pulmonary edema, alveolar collapse, and hypoxemia

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6
Q

CF of ards

A

o Rapid onset of profound dyspnea that usually occurs 12-48 hours after the initiating event.
o Labored breathing
o Tachypnea
o Frothy pink or red sputum
o Intercostal retractions
o Diffuse crackles
o ** A quiet chest, agitation or confusion are ominous signs of impending respiratory failure
o Many patients are cyanotic with increasingly severe hypoxemia that is refractory to administered oxygen

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7
Q

dx of ards

A

CXR-normal at first, but then shows diffuse or patchy bilateral infiltrates that spare costrophrenic angles

air bronchograms-80%, upper lung zone venous engorgement is distinctly UNcommon.

heart size normal

multiple organ failur is common

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8
Q

prevention of ards

A

nada. PEEP and I V methylprednisolones doesn’t prevent ards

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9
Q

tx of ards

A

tx underlying cause
o Treatment of hypoxemia seen in ARDS usually requires tracheal intubation and positive pressure mechanical ventilation. Hypoxia is often refractory to treatment
o The lowest levels of PEEP and supplemental oxygen required to maintain PAO2 above 55 mmHg or the SaO2 above 88% should be use.
o Efforts should be made to decrease FIO2 to less than 60% as soon as possible in order to avoid oxygen toxicity.
o PEEP can be increased as needed as long as cardiac output and oxygen delivery do not decrease and airway pressures do not increase excessively.
o Prone position may transiently improve oxygenation in selected patients by helping recruit atelectatic alveoli; however, great care must be taken during the maneuver to avoid dislodging catheters and tubes.

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10
Q

what is the most common cardiac failure, cardiac arrest?

A

ischemic heart dz

vtach and vfib

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