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May 12, 2016 · 3 TYPES OF RESPIRATORY FAILURE TYPE 1 (HYPOXEMIC ): PO2 < 60 mmHg on room air. TYPE 2 (HYPERCAPNIC / VENTILATORY): PCO2 > 50 mmHg TYPE 3 (PERI-OPERATIVE): This is generally a subset of type 1 failure but is sometimes considered separately because it is so common. TYPE 4 (SHOCK): secondary to cardiovascular instability.
- Respiratory Failure Causes and Treatment | PPT - SlideShare
ANJANI WALIA. This document discusses respiratory failure,...
- Respiratory Failure: Types, Causes and Treatment | PPT
Respiratory failure occurs when the lungs cannot effectively...
- Respiratory Failure Causes and Treatment | PPT - SlideShare
- Objectives
- Acute Respiratory Failure
- Hypoxemic Respiratory Failure (Type 1)
- Type 2 ( Ventilatory /Hypercapnic Respiratory Failure)
- Type 3 (Peri-Operative) Respiratory Failure
- Type 4 (Shock)
- Clinical Signs and Symptoms of Acute Respiratory Failure
- ARF : CXR Findings
- Management of Acute Respiratory Failure
Given a critically ill patient, the resident must be able to determine the presence or absence of respiratory failure, provide for its emergency support, and have a plan of action to subsequently investigate and manage the problem. These actions must be based on a sound knowledge of respiratory physiology, pathology, pathophysiology, and pharmacolo...
Definition:
The loss of the ability to ventilate adequately or to provide sufficient oxygen to the blood and systemic organs. The pulmonary system is no longer able to meet the metabolic demands of the body with respect to oxygenation of the blood and/or CO2elimination.
Classification:
1. Type 1 (Hypoxemic ) - PO2< 50 mmHg on room air. Usually seen in patients with acute pulmonary edema or acute lung injury. These disorders interfere with the lung's ability to oxygenate blood as it flows through the pulmonary vasculature. 2. Type 2 (Hypercapnic/ Ventilatory ) - PCO2 > 50 mmHg (if not a chronic CO2retainer). This is usually seen in patients with an increased work of breathing due to airflow obstruction or decreased respiratory system compliance, with decreased respiratory mu...
Etiologies:
ARF can result from a variety of etiologies. It can result from primary pulmonary pathologies or can be initiated by extra-pulmonary pathology. Causes are often multifactorial. Acute respiratory failure can be caused by abnormalities in: 1. CNS ( drugs, metabolic encephalopathy, CNS infections, increased ICP, OSA, Central alveolar hypoventilation) 2. spinal cord (trauma, transverse myelitis) 3. neuromuscular system ( polio, tetanus, M.S., M.Gravis, Guillain-Barre, critical care or steroid myo...
Physiologic Causes of Hypoxemia
1. Low FiO2(high altitude) 2. Hypoventilation 3. V/Q mismatch (low V/Q) 4. Shunt (Qs/Qt) 5. Diffusion abnormality 6. Venous admixture ( low mixed venous oxygen) Low FiO2is the primary cause of ARF only at altitude. However, it should be kept in mind that any patient who suddenly desaturates while on oxygen may have had their oxygen source disconnected or interrupted. Hypoventilation can be ruled in or out with the use of the alveolar-air gas equation. A normal A-a gradient indicates that hypo...
Physiologic causes of Hypercapnia:
1. Increased CO2 production (fever, sepsis, burns, overfeeding) 2. Decreased alveolar ventilation 1. decreased RR 2. decreased tidal volume (Vt) 3. increased dead space (Vd) The cause of hypercapnia is often independent of hypoxemia. Hypercapnia results from either increased CO2 production secondary to increased metabolism (sepsis, fever, burns, overfeeding), or decreased CO2 excretion. CO2excretion is inversely proportional to alveolar ventilation (VA). VA is decreased if total minute ventil...
Causes of decreased alveolar ventilation:
1. Decreased CNS drive ( CNS lesion, overdose, anesthesia). The patient is unable to sense the increased PaCO2. The patient "won't breathe". 2. Neuromuscular disease ( Myasthenia Gravis, ALS, Guillian-Barre , Botulism, spinal cord disease, myopathies, etc.). The patient is unable to neurologically signal the muscles of respiration or has significant intrinsic respiratory muscle weakness. The patient "can't breathe". 3. Increased Work Of Breathing leading to respiratory muscle fatigue and inad...
Evaluation of Hypercapnia:
The physiologic reasons for hypercapnia can be determined at the bedside. 1. Minute Ventilation, RR, Vt, 2. Assessment of patient's work of breathing- accessory respiratory muscle use, indrawing, retractions, abdominal paradox. 3. NIF(negative inspiratory force). This is a measure of the patient's respiratory system muscle strength. It is obtained by having the patient fully exhale. Occluding the patient's airway or endotracheal tube for 20 seconds, then measuring the maximal pressure the pat...
Type 3 respiratory failure can be considered as a subtype of type 1 failure. However, acute respiratory failure is common in the post-operative period with atelectasis being the most frequent cause. Thus measures to reverse atelectasis are paramount.In general residual anesthesia effects, post-operative pain, and abnormal abdominal mechanics contri...
Hypoperfusion can lead to respiratory failure.Ventilator therapy is often instituted in order to minimize the steal of the limited cardiac output by the overworking respiratory muscles until the etiology of the hypoperfusion state is identified and corrected. 1. cardiogenic 2. hypovolemic 3. septic
Clinical manifestations of respiratory distress reflect signs and symptoms of hypoxemia, hypercapnia, or the increased work of breathing necessary. These include 1. Altered mental status (agitation, somnolence) 2. Peripheral or central cyanosis or decreased oxygen saturation on pulse oximetry 3. Manifestations of a "stress response" including tachy...
Clear CXR with hypoxemia and normocapnia.- Pulmonary embolus, R to L shunt, ShockDiffusely white (opacified) CXR with hypoxemia and normocapnia - ARDS, NCPE, CHF, pulmonary fibrosisLocalized infiltrate - pneumonia, atelectasis, infarctClear CXR with hypercapnia - COPD, asthma, overdose, neuromuscular weaknessThe management of acute respiratory failure can be divided into an urgent resuscitation phase followed by a phase of ongoing care. The goal of the urgent resuscitation phase is to stabilize the patient as much as possible and to prevent any further life-threatening deterioration. Once these goals are accomplished the focus should then shift towards...
People also ask
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Jun 11, 2023 · Type 1 respiratory failure occurs when the respiratory system cannot adequately provide oxygen to the body, leading to hypoxemia. Type 2 respiratory failure occurs when the respiratory system cannot sufficiently remove carbon dioxide from the body, leading to hypercapnia.
- 2023/06/11
There are two common types: hypoxemic respiratory failure (type 1) and hypercapnic respiratory failure (type 2). Other types include perioperative (related to surgery) respiratory failure (type 3) and respiratory failure due to shock (type 4).
Nov 9, 2014 · Types of respiratory failure • Acute overwhelming lung disease • Bacterial or viral pneumonia • Pulm embolism • Exposure to toxic gases (chlorine, nitrogen oxides) • Neuromuscular disorders • Causes • 1) depression of breathing centers (drugs) • 2) diseases of medulla (encephalitis, trauma, hemorrhage) Fig 9-4.
