Notes in Acute Respiratory Failure

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Status	Last Update	Fields
Published	11/02/2023	4847e807fcc24dacabb742d6cf86ba9f-oa-1
Published	11/02/2023	{{c1::Acute respiratory failure}} is the inability to maintain either normal delivery of O2 to tissues OR the normal removal of CO2 from the tissues
Published	11/02/2023	Treatment of Acute respiratory failure is {{c1::O2}}, treating the {{c1::underlying condition}}, and {{c1::mechanical ventilation}} (if severe)
Published	11/02/2023	Type 1 acute respiratory failure:{{c1::Hypoxemia}}PaO2 < {{c2::60}} mmHg OR spO2 < {{c2::90}}%The problem: {{c1::oxygenation}}
Published	11/02/2023	5 reasons causing type 1 acute respiratory failure (hypoxemia){{c1::Decreased inspired O2HypoventilationDiffusion disorderV/Q mismatchShunt}}
Published	11/02/2023	Type 2 acute respiratory failure:{{c1::Hypercapnic}}PaCO2 > {{c2::45}} mmHg AND pH < {{c2::7.35}}Problem = {{c1::Ventilation}}
Published	11/02/2023	3 causes of type 2 acute respiratory failure:{{c1::HypoventilationImpaired exhalationImpaired work of breathing}}
Published	11/02/2023	The {{c1::heart}} and {{c1::brain}} are tissues that are very sensitive to O2
Published	11/02/2023	{{c1::Hypoxemia}}: {{c2::low O2 in the blood (low PaO2, low SaO2)}}{{c1::Hypoxia}}: {{c2::low O2 delivered to the tissues}}
Published	11/02/2023	IF the PaO2 drops from 100 -> 60 mmHg, the SaO2 only decreases to around {{c1::90}}%
Published	11/02/2023	Exercising muscle is {{c1::acidic}}, {{c1::hypercarbic}}, and {{c1::hot}}
Published	11/02/2023	Alveolar gas equation{{c2::PAO2}} = {{c1::150 - (PaCO2/0.8)}}
Published	11/02/2023	COPD causes low oxygenation because of {{c1::bronchoconstriction}}, the body adapts by doing {{c1::hypoxic vasoconstriction}}
Published	11/02/2023	In pulmonary embolism, you have V/Q mismatch due to {{c1::perfusion}} issues, which increases the dead space, impairing gas exchange
Published	11/02/2023	V/Q mismatch causes an {{c1::increase}} in A-a gradient and can be treated by {{c1::supplemental O2}}
Published	11/02/2023	High altitude causes hypoxemia because there is {{c1::low atmospheric O2 (PAO2)}}
Published	11/02/2023	In response to high altitude, the body compensates by {{c1::hyperventilating}}
Published	11/02/2023	A-a gradient in high altitude is {{c1::normal}}
Published	11/02/2023	Obstructed alveoli {{c1::don't::do vs. do not}} allow for full oxygenation of the arterial blood, and supplemental O2 {{c1::does not::does vs. does no…
Published	11/02/2023	Opiod overdoses cause {{c1::hypoventilation}} which can cause you to have {{c2::hypercapnia}}, {{c1::high}} PaCO2 + {{c1::low}} pH
Published	11/02/2023	PaCO2 is {{c1::inversely}} proportional to alveolar ventilation
Published	11/02/2023	Doubling ventilation reduces PaCO2 by {{c1::50}}%
Published	11/02/2023	Overdose (hypoventilation) causes the A-a gradient to be {{c1::normal}} since PAO2 and PaO2 are similarly decreased
Published	11/02/2023	a26d5e1d15354895b94ac77e06454048-oa-1
Published	11/02/2023	Diffusion limitations (ex. pulmonary fibrosis) causes you to have an {{c1::increased}} A-a gradient
Published	11/02/2023	NRDS is caused by a deficiency in {{c1::surfactant}}
Published	11/02/2023	Clinical features: Asymptomatic at birth, few hours later dyspnea, tachypnea, tachycardia, and hypoxemia will develop. Eventually, chest wall ret…
Published	11/02/2023	Treatment of NRDS is {{c1::supplemental O2}}, and in severe cases = {{c1::surfactant therapy}}
Published	11/02/2023	ARDS:{{c1::Increased}} vascular permeability{{c1::Increased}} physiological dead space{{c1::Decreased}} lung compliance
Published	11/02/2023	ARDS is located {{c1::diffusely}} in the lungs
Published	11/02/2023	Disorders associated with development of ARDS{{c1::Pneumonia (direct insult)}}{{c1::Gastric aspiration (direct insult)}}{{c1::Sepsis (indirect insult)…
Published	11/02/2023	What are the two diagnoses?Top one = {{c1::CHF}}Bottom one = {{c1::ARDS (no cardiomegaly, no effusions)}}
Published	11/02/2023	In the lungs, there are opposing {{c1::hydrostatic}} and {{c1::oncotic}} pressures which works to keep the lungs {{c2::dry}}
Published	11/02/2023	{{c1::Cardiogenic}} pulmonary edema is due to high LA pressure
Published	11/02/2023	{{c1::Non-cardiogenic}} pulmonary edema is due to injury to capillaries -> {{c2::fluid and protein}} leakage into the interstitium ({{c1::exudative…
Published	11/02/2023	The classic histopathology finding for ARDS is {{c1::diffuse alveolar damage and hyaline membrane}}
Published	11/02/2023	Non-caseating granulomas are found in {{c1::hypersensitivity pneumonitis and sarcoidosis}}Hyaline thickening + alveolar damage is found in {{c1::ARDS}…
Published	11/02/2023	Pathophysiology of ARDS:Loss of {{c1::tight junction}} and sloughing -> leakage of protein rich fluid into the alveolar space -> loss of su…
Published	11/02/2023	{{c1::Endothelial}} cells can also get injured in ARDS, allowing neutrophils, RBCs, protein into the interstitial space and then the alveolar space wh…
Published	11/02/2023	{{c2::Exudative}} phase of ARDS: days {{c1::0-7}}; hyaline membranes{{c2::Proliferative}} phase of ARDS: days {{c1::7-21}}; prominent interstitial inf…
Published	11/02/2023	COVID ARDS has extensive {{c1::thrombosis}} compared to normal ARDS
Published	11/02/2023	CXR findings of ARDS: {{c1::diffuse or patchy bilateral infiltrates}}CT chest findings of ARDS: {{c1::Heterogenous and patchy involvement; more i…
Published	11/02/2023	What helps the diagnosis? {{c1::Ground glass opacities (haziness); bilateral infiltrates}}
Published	11/02/2023	What helps the diagnosis? {{c1::Bilateral, diffuse infiltrates in more than 1 lobe, }}
Published	11/02/2023	52457884e7fa4ec9bd52b6058db4406c-oa-1
Published	11/02/2023	52457884e7fa4ec9bd52b6058db4406c-oa-2
Published	11/02/2023	52457884e7fa4ec9bd52b6058db4406c-oa-3
Published	11/02/2023	In ARDS, the baby lung has the {{c1::highest}} compliance and gets overdistended
Published	11/02/2023	In ARDS, you can have increased density of lung tissue in the posterior regions which is caused by {{c1::consolidation}} and atelectasis
Published	11/02/2023	Treatment of ARDS: {{c1::Treat the underlying cause::most important}}{{c1::Steroids}}{{c1::Mechanical ventilation}}{{c1::Prone positioning}}
Published	11/02/2023	On oxygen support, you want to get to SaO2 of {{c1::88}}-{{c1::95}}%
Published	11/02/2023	If needed in ARDS, you can give {{c1::high flow oxygen}} or {{c1::mechanical}} ventilation
Published	11/06/2023	{{c1::PEEP}} (for ARDS) is used to increase FRC, decrease alveolar edema, incorporate the collapsed alveoli, and avoid the repetitive opening an dclos…
Published	11/02/2023	Do steroids help in treating ARDS?{{c1::Yes}}
Published	11/02/2023	25d6c5f4d7a344508cc3dbddfb8e9dfb-oa-1
Published	11/02/2023	25d6c5f4d7a344508cc3dbddfb8e9dfb-oa-2
Published	11/02/2023	25d6c5f4d7a344508cc3dbddfb8e9dfb-oa-3
Published	11/02/2023	0c8a46fb93eb4041b90a285f61091eec-oa-1
Published	11/02/2023	Prone positioning in severe ARDS helps to improve V/Q matching by {{c1::improving}} the lung recruitment and {{c1::decreasing}} the release of proinfl…
Published	11/02/2023	11b91fc2b71543879dfc501ddf483299-oa-1
Published	11/02/2023	11b91fc2b71543879dfc501ddf483299-oa-2
Status	Last Update	Fields