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25 Cards in this Set
- Front
- Back
What is acute respiratory failure?
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Life-threatening condition associated with inadequate gas exchange
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What is Type I respiratory failure?
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Acute Hypoxemic Respiratory Failure
Arterial O2 saturation < 90% despite of FIO2 > 0.6 Pneumonia Pulmonary edema Pulmonary hemorrhage ARDS |
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What is Type II respiratory failure?
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Hypercarbic respiratory failure
Arterial PCO2 > 50 mmHg; arterial pH < 7.3 Neuromuscular diseases (MG, myopathies) Respiratory muscle fatigue (asthma, COPD) Diminished CNS drive to breathe (drug overdose, brain stem injury, sleep-disordered breathing, hypothyroidism) |
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What is Type III respiratory failure?
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Result of lung atelectasis (perioperative respiratory failure)
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What is Type IV respiratory failure?
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Due to hypoperfusion of respiratory muscles in shock
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What is the mechanism of hypoxemia when there is normal P(A-a)O2?
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decreased PIO2; high altitude
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What are the mechanisms of hypoxemia when there is increased P(A-a)O2?
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Ventilation-perfusion (V/Q) mismatch (i.e. airway disease, vascular disease)
Shunt (acute lung injury/ARDS, pneumonia, parenchymal lung disease, cardiogenic pulmonary edema) |
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What are the clinical manifestations of acute respiratory failure?
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Inability to maintain adequate oxygenation or inability to maintain an appropriate PaCO2
Dyspnea and tachypnea Progressive fatigue sometimes leading to respiratory arrest Neurologic function deterioration and possible myocardial ischemia or even infarction |
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What are the clinical manifestations of hypoxemia?
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Tachycardia, tachypnea, anxiety, diaphoresis, altered mental status, confusion, cyanosis, hypertension, hypotension, bradycardia, seizures, coma, lactic acidosis
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What are the clinical manifestations of hypercapnia?
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Somnolence, lethargy, restlessness, tremor, slurred speech, headache, asterixis, papilledema, coma, diaphoresis
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What are the patterns of chest radiography in acute respiratory failure?
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Normal (or relatively normal)
Localized alveolar filling opacities Diffused alveolar filling opacities |
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What is mechanical ventilation?
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Machine-supported respiratory assistance, which may completely replace or help the patients spontaneous breathing
Most commonly provided via an artificial airway |
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What are indications for intubation?
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Inability to ventilate
Inability to oxygenate adequately Excessive work of breathing Protection of the airways Hyperventilation |
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What is tidal volume (TV)?
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Volume of each breath
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What is minute ventilation (VE)?
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Total volume of air breathed during sixty seconds
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What is FIO2?
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Inspired oxygen concentration
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What is inspiratory pressure?
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Pressure at which the ventilator delivers a breath
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What is trigger pressure?
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Negative pressure a patient must achieve to initiate a ventilator-supported breath
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What is positive end-expiratory pressure (PEEP)?
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Pressure the ventilator maintains during the expiratory phase of breathing
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What is a sigh?
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Larger than normal breath delivered by the ventilator at preset intervals to expand collapsed alveoli
Used for prevention and treatment of atelectasis |
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What is control mode?
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The ventilator is set to deliver all of the ventilation
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What is assist control mode (AC mode)?
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The ventilator has a set minimum number of breaths and augments every patient respiratory effort with a preset TV
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What is intermittent mandatory ventilation (typically synchronized or SIMV)?
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The ventilator supports a preset number of breaths with a preset TV, and the patient may generate additional spontaneous TV
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What is pressure support?
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Every patient effort is supported with positive pressure at the preset level; TVs may vary from supported breath to supported breath
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What is high frequency ventilation?
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Mechanical respiratory rate is super normal, usually with smaller than normal TVs
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