5. 1,2,3
Bottom line of the respiratory system is to
Let oxygen in,
And carbon dioxide out.
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6. Definitions
acute respiratory failure occurs when:
pulmonary system is no longer able to meet the
metabolic demands of the body
hypoxaemic respiratory failure:
PaO2 8 kPa when breathing room air
hypercapnic respiratory failure:
PaCO2 6.7 kPa
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8. PAO2
The alveolar pressure is equal to the sum of
the partial pressures of the gases within the
alveolus.
The partial pressure of each gas is
proportional to the concentration of the gas.
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14. Carbon dioxide out
Largely dependent on alveolar ventilation
Alveolar ventilation RR x (V - V ) T D
Anatomical dead space constant but
physiological dead space depends on ventilation-
perfusion matching
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18. Pathophysiology
Low inspired Po2
Although, in theory, acute respiratory failure may
result from a low inspired PO2 this is rarely a
problem in Intensive Care except in locations at
high altitude.
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33. Diffusion abnormalities.
These can result from a failure of diffusion
across the alveolar membrane
or a reduction in the number of alveoli
resulting in a reduction in the alveolar surface
area.
Causes include ARDS and fibrotic lung
disease
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46. The oxygen content of blood is mainly
dependent on:
the haemoglobin saturation,
with the a very small contribution from dissolved
oxygen.
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52. Summary
worry if
RR > 30/min (or < 8/min)
unable to speak 1/2 sentence without pausing
agitated, confused or comatose
cyanosed or SpO2 < 90%
deteriorating despite therapy
remember
normal SpO2 does not mean severe ventilatory problems are not
present
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82. Hypoxic
Yes No
Acidosis
Shock
PE
Asthma
Pumonary
edema
Anxiety
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83. Hypoxic
Pco2
Low Pco2
High /normal
pneumonia
ARDS
Pulmonary
edema
Aspiration
PE
pneumothorax
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84. Hypoxic
Pco2
Low Pco2
High /normal
Normal A-a High A-a
gradient gradient
Breathing Breathing Fatigue from
hard normally hypoxia
Acute on
Asthma CND
chronic
COPD Drugs
PE
Ihab Tarawa 10/2/2012 84