Acute Resp Failure 4.18.58 PM

Acute Resp Failure 4.18.58 PM - Acute Respiratory Failure...

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Unformatted text preview: Acute Respiratory Failure Acute Respiratory Failure Cindy Kin Trauma Conference 6 August 2007 Stanford Surgery Acute Respiratory Failure Acute Respiratory Failure • Failure in one or both gas exchange functions: oxygenation and carbon dioxide elimination • In practice: PaO2<60mmHg or PaCO2>46mmHg • Derangements in ABGs and acid-base status Acute Respiratory Failure Acute Respiratory Failure • Hypercapnic v Hypoxemic respiratory failure • ARDS and ALI Hypercapnic Respiratory Failure Hypercapnic Respiratory Failure (PAO2 - PaO2) Alveolar Hypoventilation V/Q abnormality ↓ PI max increased normal Nl VCO2 PaCO2 >46mmHg Not compensation for metabolic alkalosis Central Hypoventilation Neuromuscular Problem ↑ VCO2 V/Q Abnormality Hypermetabolism Overfeeding The Case of Patient RV The Case of Patient RV 71M s/p L AKA revision. PMH: CAD s/p CABG, COPD on home O2 and CPAP, DM, CVA, atrial fibrillation PACU: L pleural effusion, hypotension, altered mental status. Sent to ICU for monitoring. POD#1: ↑ RR overnight, intermittently hypoxic. BiPAP 40%: 7.34/65/63/35/+10 Preintubation: 7.28/91/81/43 Hypercapnic Respiratory Failure Hypercapnic Respiratory Failure (PAO2 - PaO2) Alveolar Hypoventilation V/Q abnormality ↓ PI max increased normal Nl VCO2 PaCO2 >46mmHg Not compensation for metabolic alkalosis Central Hypoventilation Neuromuscular Problem ↑ VCO2 V/Q Abnormality Hypermetabolism Overfeeding Hypercapnic Respiratory Failure Hypercapnic Respiratory Failure Alveolar Hypoventilation Brainstem respiratory depression Drugs (opiates) Obesity-hypoventilation syndrome ↓ PI max Central Hypoventilation Neuromuscular Disorder nl PI max Critical illness polyneuropathy Critical illness myopathy Hypophosphatemia Magnesium depletion Myasthenia gravis Guillain-Barre syndrome Hypercapnic Respiratory Failure...
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  • Fall '11
  • Dr.Aslam
  • Respiratory distress, Acute respiratory distress syndrome, respiratory failure, hypoxemic respiratory failure

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Acute Resp Failure 4.18.58 PM - Acute Respiratory Failure...

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