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Acute Resp. Failure
RESP: Acute Respiratory Failure
| Question | Answer |
|---|---|
| hypoxemia | PaO2 <60 failure of respiration/oxygenation |
| hypercapnia | PaCO2 >50 failure of ventilation |
| state of disturbed gas exchange resulting in abnormal ABGs? | acute respiratory failure |
| tidal volume (Vt) | 500 mL air/breath |
| anatomic dead space (ADS) | Vt/3 500/3 = 150 mL/breath |
| alveolar ventilation volume (AVV) | Vt - ADS 500 - 150 = 350 mL/breath |
| alveolar ventilation rate (V) | AVV X RR 350 X 12bpm = 4.2 L/minute |
| pulmonary perfusion rate (Q) | volume of blood in the pulmonary circulation per minute 5 L/minute |
| V/Q Match | 4.2/5.0 = .8 which is almost 1 |
| what are the determinants of adequate alveolar ventilation? | V: adequate air intake Q: adequate perfusion in pulmonary circulation |
| causes of V/Q mismatch? | bronchitis <1 and emphysema >1 |
| primary clinical manifestations of ARF? | hypoxemia and hypercapnia |
| early clinical manifestations of ARF? | confusion, headache, restlessness, tremors, tachycardia, HTN |
| late clinical manifestations of ARF? | coma, bradycardia, hypotension, pulmonary HTN, cyanosis, respiratory arrest |
| what is acute respiratory distress syndrome (ARDS)? | -infiltrative lung lesions -severe refractory arterial hypoxemia -life threatening respiratory distress |
| precipitating events of ARDS (categories)? | -direct injury/physical source -inhalation or airway source -blood borne or vascular source |
| reason why severe refractory arterial hypoxemia sucks so much? | doesnt respond to oxygen --> ventilator |
| top two precipitating events of ARDS? | aspiration and sepsis |
| synonymous terms for ARDS? | -septic lung -wet lung -white lung -capillary leak syndrome -shock lung -noncardiogenic pulmonary edema |
| clinical manifestations of initial ARDS stage? | -insidious (sudden) onset -dyspnea -restlessness -rales -XRAYS: minimal infiltrates |
| primary clinical manifestations of ARDS? | pulmonary edema and decreased lung compliance |
| clinical manifestations of second ARDS stage? | -noisy tachypneic breathing -tachycardia -diaphoresis -decreased mentation -pallor, cyanosis (resp. distress) -XRAYS: extensive, bilateral infiltrates and cardiomegaly |
| clinical manifestations of final ARDS stage? | -intubation and assisted ventilation -bronchial breath sounds -severe metabolic acidosis -death -XRAYS: white out/white lung |
| complications of ARDS? | -disturbances in cardiac rhythm -secondary to bacterial infections -sepsis -stress ulcers -DIC |
| most frequent histopathologic finding of ARDS? | capillary leakage |
Created by:
rebecky
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