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Acute Resp. Failure

RESP: Acute Respiratory Failure

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