Respiratory Support Flashcards
What are the options for supporting a patient’s respiratory system?
Least to most invasive
- O2 therapy
- high flow nasal cannula
- non- invasive ventilation
- intubation + mechanical ventilation
- extracorporeal membrane oxygenation
Clinical findings of acute respiratory distress syndrome
- acute respiratory distress
- hypoxia with inadequate response to O2
- bilateral infiltrates on chest x ray
What occurs in acute respiratory distress syndrome?
- occurs due to severe inflammatory reaction in lungs
- often secondary to sepsis or trauma
- atelectasis
- pulmonary oedema
- decreased lung complicance
- fibrosis of the lung (if >10days)
Management of acute respiratory distress syndrome
- respiratory support PEEP
- prone positioning
- careful fluid management to avoid excess fluid in the lungs
What type of mechanical ventilation is used during acute respiratory disasters syndrome?
Why?
Positive end-expiratory pressure
To prevent the lungs from collapsing further
Why should you position a person in acute respiratory distress in a prone position?
- reduces compression of lungs from other organs
- improves blood flow to lungs
- improves secretion clearance
- improves overall oxygenation
- reduces need for mechanical ventilation
What masks can be used to deliver oxygen?
- nasala cannula
- simple face mask
- Venturi mask
- non-rebreather mask
What oxygen mask would you use in COPD patients and why?
Venturi mask
Can be used to deliver the exact conc of O2
What is the function of positive end expiratory pressure?
Helps keep the airways from collapsing + improves ventilation
What ways can positive end expiratory pressure be added?
- high flow nasal cannula
- non invasive ventilation
- mechanical ventilation
Benefits of high flow nasal cannula
- non invasive
- high flow rate increases concentration of oxygen inhaled + provides dead space washout
- adds some positive end expiratory pressure
What is dead space washout?
- physiological dead space is the air that does not contribute to gas exchange as it doesn’t reach the alveoli
- high flow oxygen clears this + replaces it with oxygen
- improves patient oxygenation
What condition commonly uses CPAP (continuous positive airway pressure)?
Obstructive sleep apnoea
Outline CPAP
Involves a constant pressure added to the lungs to keep airways expanded
Why is CPAP not classed as non invasive ventilation?
It does not involve ventilation
Ventilation is still dependent on respiratory muscles
What does non-invasive ventilation involve?
Using a full face mask, hood or tight fitting nasal mask to blow air into the lungs to ventilate them
- cycle of IPAP + EPAP
What machine proves NIV?
Bilevel positive airway pressure
When is mechanical ventilation used?
When other forms of respiratory support are inadequate or contraindicated
What are some key modes of mechanical ventilation?
- volume controlled ventilation
- pressure controlled ventilation
- assist control: breaths are triggered by the patient
- continuous positive airway pressure
What is extracorporeal membrane oxygenation?
- Blood in removed from the body
- passed through a machine where O2 is added + CO2 is removed
- blood pumped back into body
like haemodialysis
When is extracorporeal membrane oxygenation used?
- When respiratory failure is not adequately managed by intubation + ventilation
- If there is a potentially reversible cause of the resp failure
