AnesCoex Wk3

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Author:
Anonymous
ID:
62031
Filename:
AnesCoex Wk3
Updated:
2011-01-25 19:36:12
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AnesCoex Wk3 Respiratory Failure
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AnesCoex Wk3 - Respiratory Failure
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  1. 1. Define respiratory failure, how is it characterized?

    What is the difference between pump and lung failure -what are the classic examples?
    • Impaired gas exchange that causes hypoxemia, hypercapnia or both
    • [O2 and/or Co2 levels cannot be maintained at physiologically normal levels]

    Characterizations: Acute/Chronic; Lung/Pump

    • Lung failure (hypoxemia) - impaired gas exchange (e.g. ARDS)
    • Pump failure (hypercapnea) - impaired ventilation (e.g. drug overdose)
  2. 4. What are examples of pump vs. lung failure
    • Pump failure
    • Brain: OD, CVA, Heart trauma
    • Neuro: MG, Polio, GB, Spinal cord trauma/tumor
    • Chest wall: Flail Chest, Kyphosis, Burn Eschar
    • Upper Airway: Vocal cord paralysis/paradoxical motion; tracheal stenosis/laryngospasm

    • Lung failure
    • Lower Airway & Lung: COPD, ARDS, PE, pna, Alveolar hemorrhage
    • Heart: CHF, Valvular disease
  3. 5. What can you use to diagnose respiratory failure?

    7. What are the symptoms you will find in respiratory failure?
    • 1. H&P
    • 2. Lab workup
    • *not just looking to classify, e.g. acute/chronic, lung/pump... but you want to subdiagnose, e.g. acute vs chronic

    • S/Sx:
    • CNS: headache, visual disturbance, confusion, memory loss, hallucination, LOC (CNS vulnerable to ischemic changes)
    • Resp: Dyspnea (resting vs. exertion), cough, sputum (e.g. copd), chest pain
  4. 6. Why are ABGs so essential in respiratory failure? What information does it give?

    How is acute vs. chronic defined?
    - ABG is the most important test to subclassify respiratory failure, e.g. acute vs chronic or lung vs pump

    - Provides an indication of the duration and severity of respiratory failure

    • Gives 3 types of information:
    • - Presence and degree of hypoxemia (PaO2)
    • - Presence and degree of hypercapnia (PaCo2)
    • - Arterial blood pH

    Acute/Chronic determined based on PaCo2 vs pH (acute = high PCO2/low pH; chronic = high PCO2/normal pH)
  5. 8. What can you give for pump failure? for lung failure?
    • Pump failure (hypercapnea)
    • - correct electrolyte imbalance
    • - nutrition
    • - rehab
    • - reduce wob (CPAP, PPV)

    • Lung failure (hypoxemia)
    • - Medicate (bronchodilators, steroids, methylxanthines, antibiotics, oxygen)
    • - Surgery (bullectomy, lung transplant)

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