Perfusion of pulmonary capillaries. hyperventilation and resultant resp alkalosis(decrea sed PaCO2 and increased pH). -if has ventilator difficulties hypoxemia can be complicated by hypercapnia and resp acidosis. -widespread tissue dysfunction andwhen severe-organ infarction. -pulmonary artery hypertension due to hypoxic pulm vasoconstriction contributing to increase pressure in pulm artery which can lead to right sided heart failure and cor pulmonale -clinical manifestations: cyanosis, confusion, tachycardia, edema, decreased renal output. respiratory system is responsible for oxygen and carbon dioxide exchange between the blood and the atmosphere. Respirat ory failure occurs when this exchange fails and metabolic demands for oxygen and body system acid- base stabilization are not maintained, creating a ventilation- perfusion mismatch. Look in page 1251- 1252 (what else?) Hypercap nic Respirator y Failure -definition: increase CO2 concentration in arterial blood (increase PaCO2), caused by hypoventilation of alveoli. -causes: decrease drive to breathe or inadequate ability to respond to ventilator stimulation: 1. - hyperventilation often overlooked because breathing pattern and ventilation rate may aoppear normal; it is important to obtain blood Per google, Hypoxemic respirator y failure (type I) is characterized by an arterial oxygen tension (PaO 2 ) lower than 60 mm Hg with a normal or low arterial carbon dioxide tension (PaCO 2 ). ... Acute hypercapnic respiratory -?
Depression of resp center by drugs 2. Disease of medulla(infections of CNS), 3. Abnormalities of spinal conducting pathways(spinal cord disruption or poliomyelitis) 4. Disease of neuromuscular junction or of the resp muscles themselves (myasthenia gravis or muscular dystrophy) 5. Thoracic age abnormalities(chest injury or deformity), 6. Large airway obstruction (tumors or sleep apnea), 7. Increase work of breathing or physiologic dead space(emphysema) gas analysis to determine severity of hypercapnia and resultant resp acidosis. -clinical manifestations: electrolyte imbalance due to low pH that may cause dysrhythmias, somnolence, coma due to changes in intracranial pressure associated w/high level of arterial carbon dioxide, causing cerebral dialation. Alveolar hypoventilation w/increase alveolar carbon dioxide limits amount of alveolar oxygen available for diffusion into blood, leading to secondary hypoxemia. failure develops over minutes to hours; therefore, pH is less than 7.3. Acute Lung Injury / Acute Respirator y Distress Syndrome ; pg 1261- 1263 -definition: spectrum of acute lung inflammation and diffuse alvelocapillary injury. -older people and those w/sever infections or immunocompromised =high mortality. -most common predisposing factors: genetic factors, sepsis, multiple trauma (multiple transfucions). -Other causes: PNA, burns, aspiration, -LOOK AT CLINICAL MANIFESTATION ON PG 1263 -All disorders that result in ARDS cause acute injury in alvelocapillary membrane producing massive pulmonary inflammation, increase capillary permeability, severe pulmonary edema, shuntin, V/Q mismatch, hypoxemia. Lung inflammation and injury damages the alveolar epithelium
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- Fall '17
- pulmonary edema, pulmonary artery