Respiration and Ventilation Overview

Respiration and Ventilation

• Respiration involves gas exchange (oxygen and carbon dioxide) in the lungs, particularly in the alveoli.
• Ventilation refers to the mechanical process of inhaling and exhaling air, which brings oxygen into the body and removes carbon dioxide.
• Positive pressure generated during inspiration enhances ventilation, analogous to opening windows for fresh air circulation.

Upper Respiratory Airway Obstruction

• Obstructive Sleep Apnea (OSA) is characterized by repeated upper airway obstruction and decreased ventilation during sleep.
• Symptoms of OSA include snoring, excessive daytime sleepiness, and reports of apneic episodes from significant others.
• Risk factors for OSA include obesity, male gender, postmenopausal status, and advanced age.

Assessment and Diagnostic Findings

• Polysomnography (sleep study) is the definitive test for diagnosing OSA.
• Structural changes in the airway, such as tonsillar hypertrophy and variations in craniofacial structures, may contribute to OSA.

Medical Management

• Weight loss and avoidance of alcohol can improve ventilatory function in patients with OSA.
• Positional therapy and oral appliances, like CPAP (Continuous Positive Airway Pressure), are commonly used for treatment.
• Management of nasal obstruction may involve nasal corticosteroids, leukotriene inhibitors, and antibiotics for bacterial infections.

Surgical Management

• Surgical options include functional rhinoplasty to treat nasal obstructions.
• Procedures may involve the reduction of turbinate hypertrophy and removal of any foreign objects.

Nursing Management

• Elevating the head of the bed postoperatively aids drainage and reduces discomfort from edema.
• Frequent oral hygiene is recommended to alleviate dryness caused by mouth breathing.
• Symptoms of airway obstruction include lowered oxygen saturation and retractions in the neck or abdomen, indicating respiratory distress.

Laryngeal Obstruction

• Immediate interventions for laryngeal obstruction may include epinephrine and corticosteroids to reduce laryngeal edema.
• The head-tilt/chin-lift maneuver can help open the airway by displacing the tongue forward.
• In cases of obstructed airflow, cardiopulmonary resuscitation (CPR) should be initiated if no air passage is detected.