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Questions and Answers
What is a defining characteristic of respiratory failure?
What is a defining characteristic of respiratory failure?
Which of the following conditions is NOT a cause of respiratory failure?
Which of the following conditions is NOT a cause of respiratory failure?
What symptom is associated with hypoxia during respiratory failure?
What symptom is associated with hypoxia during respiratory failure?
Which type of respiratory failure requires controlled oxygen therapy?
Which type of respiratory failure requires controlled oxygen therapy?
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What is a common feature of ventilator masks used in oxygen therapy?
What is a common feature of ventilator masks used in oxygen therapy?
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Which finding would indicate hypercapnia in a patient?
Which finding would indicate hypercapnia in a patient?
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What is the primary aim of investigations in respiratory failure?
What is the primary aim of investigations in respiratory failure?
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In managing Type I respiratory failure, what therapeutic approach should be prioritized?
In managing Type I respiratory failure, what therapeutic approach should be prioritized?
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Study Notes
Definition of Respiratory Failure
- Respiratory failure is characterized by inadequate gas exchange, leading to hypoxia (PaO2 < 60 mmHg).
- Causes include alveolar hypoventilation and potential ventilation/perfusion (V/Q) mismatch.
Causes of Respiratory Failure
-
Pulmonary Diseases:
- Severe asthma
- Chronic obstructive pulmonary disease (COPD)
- Pneumonia
- End-stage pulmonary fibrosis
- Obstructive sleep apnea
-
Reduced Respiratory Drive:
- Sedative drugs
- CNS tumors
- Trauma
-
Neuromuscular Diseases:
- Cervical cord lesions
- Diaphragmatic paralysis
- Poliomyelitis
- Myasthenia gravis
- Guillain–Barré syndrome
-
Thoracic Wall Diseases:
- Flail chest
- Kyphoscoliosis
Clinical Features
- Symptoms of hypoxia include:
- Dyspnea
- Restlessness
- Agitation
- Confusion
- Central cyanosis
- Long-term hypoxia can lead to:
- Polycythemia
- Pulmonary hypertension
- Cor pulmonale
- Symptoms of hypercapnia include:
- Headache
- Peripheral vasodilation
- Tachycardia
- Bounding pulse
- Tremor/flap
- Papilledema
- Confusion
- Drowsiness
- Coma
Investigations
- Blood tests: Full blood count (FBC), urea & electrolytes (U&E), C-reactive protein (CRP), arterial blood gases (ABG).
- Radiology: Chest X-ray (CXR).
- Microbiology: Sputum and blood cultures if febrile.
Management Strategies
-
Type I Respiratory Failure:
- Treat the underlying cause.
- Administer oxygen via facemask to alleviate hypoxia.
- Consider assisted ventilation as needed.
-
Type II Respiratory Failure:
- Address the underlying cause.
- Utilize controlled oxygen therapy.
- Employ assisted ventilation, with intubation considered if other treatments fail.
- Oxygen delivery methods include:
- Nasal Cannulae: Well-accepted by patients; offers imprecise O2 delivery and potential nasal soreness.
- Simple Face Mask: Varies O2 delivery based on inflow rate; risk of CO2 accumulation.
- Venturi Mask: Provides controlled FiO2 at high flow rates; start at 24-28% for COPD patients.
- Non-rebreathing Mask: Equipped with a reservoir bag; capable of delivering high O2 concentrations (60-90%).
- Non-invasive Ventilation: Such as CPAP/BiPAP.
- Invasive Ventilation: Considered in severe cases.
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Description
This quiz covers the critical topic of respiratory failure, defined by inadequate gas exchange leading to hypoxia. Key causes of respiratory failure such as pulmonary diseases, reduced respiratory drive, and neuromuscular diseases are emphasized. Test your understanding of the underlying mechanisms and conditions associated with this medical emergency.
