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25 Cards in this Set

  • Front
  • Back
What is acute respiratory failure?
Life-threatening condition associated with inadequate gas exchange
What is Type I respiratory failure?
Acute Hypoxemic Respiratory Failure
Arterial O2 saturation < 90% despite of FIO2 > 0.6
Pneumonia
Pulmonary edema
Pulmonary hemorrhage
ARDS
What is Type II respiratory failure?
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)
What is Type III respiratory failure?
Result of lung atelectasis (perioperative respiratory failure)
What is Type IV respiratory failure?
Due to hypoperfusion of respiratory muscles in shock
What is the mechanism of hypoxemia when there is normal P(A-a)O2?
decreased PIO2; high altitude
What are the mechanisms of hypoxemia when there is increased P(A-a)O2?
Ventilation-perfusion (V/Q) mismatch (i.e. airway disease, vascular disease)
Shunt (acute lung injury/ARDS, pneumonia, parenchymal lung disease, cardiogenic pulmonary edema)
What are the clinical manifestations of acute respiratory failure?
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
What are the clinical manifestations of hypoxemia?
Tachycardia, tachypnea, anxiety, diaphoresis, altered mental status, confusion, cyanosis, hypertension, hypotension, bradycardia, seizures, coma, lactic acidosis
What are the clinical manifestations of hypercapnia?
Somnolence, lethargy, restlessness, tremor, slurred speech, headache, asterixis, papilledema, coma, diaphoresis
What are the patterns of chest radiography in acute respiratory failure?
Normal (or relatively normal)
Localized alveolar filling opacities
Diffused alveolar filling opacities
What is mechanical ventilation?
Machine-supported respiratory assistance, which may completely replace or help the patients spontaneous breathing

Most commonly provided via an artificial airway
What are indications for intubation?
Inability to ventilate
Inability to oxygenate adequately
Excessive work of breathing
Protection of the airways
Hyperventilation
What is tidal volume (TV)?
Volume of each breath
What is minute ventilation (VE)?
Total volume of air breathed during sixty seconds
What is FIO2?
Inspired oxygen concentration
What is inspiratory pressure?
Pressure at which the ventilator delivers a breath
What is trigger pressure?
Negative pressure a patient must achieve to initiate a ventilator-supported breath
What is positive end-expiratory pressure (PEEP)?
Pressure the ventilator maintains during the expiratory phase of breathing
What is a sigh?
Larger than normal breath delivered by the ventilator at preset intervals to expand collapsed alveoli

Used for prevention and treatment of atelectasis
What is control mode?
The ventilator is set to deliver all of the ventilation
What is assist control mode (AC mode)?
The ventilator has a set minimum number of breaths and augments every patient respiratory effort with a preset TV
What is intermittent mandatory ventilation (typically synchronized or SIMV)?
The ventilator supports a preset number of breaths with a preset TV, and the patient may generate additional spontaneous TV
What is pressure support?
Every patient effort is supported with positive pressure at the preset level; TVs may vary from supported breath to supported breath
What is high frequency ventilation?
Mechanical respiratory rate is super normal, usually with smaller than normal TVs