1. Type 1 Acute Respiratory Failure

NUR 254 ARDS 1

• Type 1 Acute Respiratory Failure

Answer Hypoxemic

• Type 2 Acute Respiratory Failure

Answer Hypercapnic

• Hypoxemic respiratory failure (T1) is characterized by...

Answer PaO2 <60 mmHg despite increased inspired O2 with a normal or low PaCO2.

• Hypercapnic respiratory failure (T2) is characterized by...

Answer respiratory acidosis, PaCO2 > 50 mmHg, and pH <7.35... hypoxemia may or may not be present

• Risk Factors for acute resp. failure

Answer

• Impaired Ventilation (Hypoventilation)

• Ventilation Perfusion Mismatch
• Impaired Diffusion (Alveolar)

• RF for acute resp. failure

Answer Impaired ventilation (hypoventilation) causes

• Airway obstruction 1 / 3

-Resp muscle weakness/paralysis, sometimes caused by myasthenia gravis

• Chest-wall injury

-Anesthesia

• opioid administration

• RF for acute resp. failure

Answer Ventilation-Perfusion Mismatch causes

- COPD

• Restrictive lung disease (sarcoidosis, pulmonary fibrosis)
• Atelectasis Pulmonary embolus
• Pneumothorax

• RF for acute resp. failure

Answer Impaired Diffusion (Alveolar) causes

• Pulmonary edema

- ARDS

• Diagnostics done for Acute Resp. Failure

Answer

• ABGs (hypoxemic - initially alkolotic... hypercapnic - acidotic w/or w/out hypoxemia)

• H/H

-C X-ray

• Sputum Cx

• Treatment for Acute Resp. Failure

Answer Not a disease... must treat CAUSE 2 / 3

• What is ARDS?

Answer A severe form of acute resp. failure

• non-cardiac pulmonary edema with refractory hypoxemia (despite hi flow O2)

• ARDS is defined by the following characteristics

Answer

• Acute onset of <7 days

• Refractory hypoxemia
• Bilateral infiltrates R/O cardiac pulmonary edema as cause

• Causes of ARDS (Direct & Indirect) ... most common?

Answer Common

Sepsis Direct

• Pneumonia

-Severe trauma

• aspiration
• Inhalation injury
• Pulmonary contusion
• PE

Indirect

-Sepsis, shock

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