Respiratory Failure

Respiratory failure is an inability of the lungs to maintain oxygenation and carbon dioxide elimination.

There are two types - hypoxia (pO2 less than 90) or hypercapnea (pCO2 increased to the point of somnolence).

 

 

 

Causes of Respiratory Failure

Hypoxemic respiratory failure

Hypercapnea

 

acute overwhelming lung disease

neuromuscular problems

acute on chronic lung disease

ARDS

IRDS

 

The five physiologic mechanisms of arterial hypoxia include:

cannot breathe, too tired to breathe, will not breathe, can't breathe enough

 

Post-operative patients experience pain, secretions, and pain medications. The most affected patients include thoracics and upper abdominal patients.

 

Closing volume is the point at which lung tissue becomes atalectatic.

Secretions (pneumonia, smoking) increase closing volume.

 

Approach to Respiratory Failure

Symptoms include, cyanosis, tachycardia, and confusion. Hypercapnea can lead to headache, papilledema, and asterexis.

 

chest X-ray

cardiogram

blood gases or oxygen saturation

 

 

 

 

 

Treatments

Hypercapnic respiratory failure requires ventilation. If, with ventilation, pO2 remains low -

Treat the underlying condition.