Acute Respiratory Failure (ARF) Overview

Abnormal heart rhythms.

Medications like heparin, lovenox, and some STDs help stimulate protein C (an antiplatelet).

Treatments include PPIs, H2 blockers, and reducing stressors to lower stomach acid.

Optimize oxygenation, provide comfort/support, monitor for complications, and educate patients/families during Acute Respiratory Distress.

Impaired gas exchange, ineffective airway clearance, ineffective breathing pattern, and dysfunctional ventilator weaning response are potential diagnoses in Acute Respiratory Distress.

A method of respiratory support that uses a mask to deliver positive pressure to the lungs, without intubation.

Delivers heated, humidified oxygen, improving oxygenation and potentially reducing airway inflammation.

Conditions like hemodynamic instability, decreased level of consciousness, or excessive secretions may prohibit NIPPV, requiring intubation instead.

ARDS is categorized into mild, moderate, and severe based on blood oxygen levels.

Measure of how well the lungs are transferring oxygen from inhaled air to the blood.

PaO2/FiO2 ratio between 200-300 mmHg with PEEP/CPAP ≥ 5 cm H2O.

PaO2/FiO2 ratio between 100-200 mmHg with PEEP ≥ 5 cm H2O.

PaO2/FiO2 ratio ≤ 100 mmHg with PEEP ≥ 5 cm H2O.

Foreign material in the lungs such as food or liquids.

Body's potentially life-threatening response to an infection.

Low oxygen levels in the blood.

Delivers high flow rates of oxygen to meet a patient's increased inspiratory demands.

Intubation is needed when a patient has airway obstruction, lacks protective reflexes, requires suctioning, or needs ventilation assistance.

Maintaining an open airway. Methods include oxygen, suctioning, airway devices (nasopharyngeal, oropharyngeal), endotracheal tubes (ETT), and bronchodilators.

Essential equipment includes suction equipment, oxygen, airways, monitoring devices, emergency medications, and an Ambu bag.

A method used when a patient is in respiratory distress or anticipates apnea.

Signs include asymmetrical chest expansion, decreased oxygen saturation, and mental status changes.

Indicates obstruction or interference with the ventilator and the patient's breathing, such as coughing, secretions or condensation.

Indicates a disconnection in the ventilator circuit.

Blood passing through the lungs without participating in gas exchange, like a traffic jam in the lungs.

Imbalance between ventilation (air flow) and blood flow in the lungs, hindering gas exchange.

A condition with a low blood pH and high carbon dioxide (PaCO2) levels.

Low blood oxygen levels that do not improve with supplemental oxygen. A sign of severe lung damage.

Dyspnea, non-productive cough, restlessness, clear chest X-ray, and respiratory alkalosis.

Chest x-ray shows infiltration, respiratory acidosis, retractions, accessory muscle use, and pallor/cyanosis.

Arterial blood gas (ABG) analysis is used in diagnosing acute respiratory failure.

A mechanical ventilation method to keep airways open at the end of exhalation, ensuring alveoli fill with air and improving oxygenation.

A type of respiratory failure where the lungs are not able to transfer enough oxygen into the blood. This is defined by a PaO2/FiO2 ratio of less than 50.

A type of respiratory failure where the lungs are not able to effectively remove carbon dioxide from the blood. This is often accompanied by a low pH (acidosis).

A measurement of the carbon dioxide concentration in exhaled breath. It can be used to assess how well the lungs are ventilating.

A procedure where a needle is inserted into the chest cavity to remove fluid from the space between the lungs and the ribcage.

A component of the blood that reflects kidney function. Bicarbonate helps to regulate blood pH by removing excess acid.

Endotracheal tube, a plastic tube inserted through the mouth or nose into the trachea, used to assist breathing.

A collection of pus in the tissue surrounding the cricoid cartilage, a ring-shaped cartilage in the larynx (voice box).

Sedatives relax the patient and prevent discomfort and anxiety during intubation, making the procedure safer.

Medications that block the nerve signals that control muscle movement. They paralyze muscles, including the diaphragm, making artificial ventilation possible.

Problems that can occur during or after intubation, including: tracheoesophageal fistula (connection between trachea and esophagus), cricoid abscess (pus in the cricoid cartilage), tracheal stenosis (narrowing of the trachea), and tube obstruction.

Lung injury caused by too much pressure in the lungs during mechanical ventilation.

Extracorporeal membrane oxygenation, a life-support system that takes over the function of the lungs outside the body.

Severe respiratory or cardiac failure, where the body's natural systems are unable to provide enough oxygen to organs.

Medications like albuterol (and similar 'ol' ending drugs) relax the airway muscles, opening up breathing passages.

Corticosteroids reduce swelling and inflammation in the lungs, helping to improve breathing.

Diuretics remove excess fluid from the body, while mucolytics (like Mucinex) loosen thick mucus, improving oxygen levels.

Pneumonia acquired outside of a hospital setting, often caused by viruses or bacteria.

Pneumonia that develops in hospitalized patients, often due to exposure to bacteria in the hospital environment.

Pneumonia that develops in patients on mechanical ventilation, often due to poor infection control.

Using pulse oximetry and ABGs, doctors monitor and adjust oxygen therapy levels to ensure adequate blood oxygenation.

Brain dysfunction caused by low oxygen levels, leading to confusion, disorientation, and altered mental state.

HFNC can provide high oxygen flow rates, improve oxygenation, reduce airway inflammation, and is often more comfortable than other non-invasive ventilation methods.

Intubation is necessary when a patient has an airway obstruction, lacks protective reflexes, requires suctioning, or needs ventilation assistance.

Positive End-Expiratory Pressure. A mechanical ventilation technique that keeps airways open at the end of exhalation to improve oxygenation and reduce lung collapse.

PEEP improves oxygenation by reducing atelectasis (lung collapse) and decreasing the effort needed for breathing by keeping airways open.

PEEP can cause complications like reduced cardiac output (heart pumping blood), barotrauma (lung injury from pressure), and increased intrathoracic pressure.

Lying on the stomach/front, helps expand the lungs, improving oxygenation in ARF.

A life-support system that filters and oxygenates blood outside the body, used when conventional ventilation fails to meet oxygen demands in severe lung or heart failure.

Optimizing oxygenation, ventilation, positioning, preventing desaturation, clearing secretions, monitoring, providing comfort and emotional support.

Substernal chest pain (behind the breastbone) worse with deep breaths, rising CO2 levels, sore throat, and eye/ear discomfort.

PEEP can lower CO by reducing venous return to the heart. Treatment involves giving fluids and medication to strengthen the heart, and potentially reducing the PEEP level.

Chest X-ray shows infiltrations (white spots), respiratory acidosis, retractions (chest pulling in), accessory muscle use (using extra muscles to breathe), and pallor/cyanosis (pale/blue skin).

Diagnosed through arterial blood gas (ABG) analysis, complete blood count (CBC) to rule out infection, a chest X-ray, and assessment of refractory hypoxemia.

Confirming the endotracheal tube (ETT) is correctly placed in the trachea (windpipe), not the esophagus (food pipe).

Potential problems that can arise from an endotracheal tube, such as a connection between the trachea and esophagus, a pus buildup near the voice box, a narrowed airway, or a blocked tube.

Sedatives calm the patient and prevent discomfort and anxiety during intubation, making the procedure safer.

Potential problems associated with using a mechanical ventilator, such as irregular heart rhythms, low blood pressure, malfunctioning equipment, accidental tube removal, anxiety, hospital-acquired pneumonia, lung injury, and reduced heart output.

Extracorporeal membrane oxygenation, a life support system that acts like the lungs outside the body, oxygenating blood with a machine and returning it to the patient's body.

ECMO is used for severe respiratory or cardiac failure when the body can't deliver enough oxygen to its organs on its own.