Respiratory Failure

Respiratory Failure :-

Definition -

Respiratory Failure Is An Alteration In The Function Of Respiratory Gas Exchange System In Either O2 And CO2 Called Respiratory Failure.

NOTE - NORMAL VALUE

• PAO2 - 75-100 MM OF HG.
• PACO2 - 38-42 MM OF HG.

Hypoxemic Respiratory Failure (Type 1) -

Characterized By Decrease Pao2 Level That Is 60 MM OF HG (Hypoxemia)

&

Paco2 Level Normal Or Low.

Hypercapnic Respiratory Failure (Type 2) -

Characterized By Increase Paco2 Level That Is 50 MM OF HG (Hypercapnia)

&

Pao2 Level Normal Or Low.

Classification -

1. Acute Respiratory Failure
2. Chronic Respiratory Failure

1. Acute Respiratory Failure -

Characterized By Hypoxemia And Hypercapnia And Acidosis (PH Less Than 7.35).

Occur Rapidly,Usually In Minute To Hour Or Days.

2. Chronic Respiratory Failure -

Characterized By Hypoxemia And Hypercapnia With A normal PH (7.35-7.45).

Occur Over A Period Of Days To Month To Year.

Etiology -

1. Cardiogenic Pulmonary Edema (Left Sided Heart Failure)
2. ARDS (Acute Respiratory Distress Syndrome)
3. Shock
4. Sepsis
5. Pneumonia
6. Trauma
7. Fat Emboli
8. Head Injury
9. Lung Trauma
10. Inhaled Toxins
11. Smoke
12. Massive Transfusion
13. Pancreatitis Uremia.

Pathophysiology -

1. Due To Etiology Cause OR Abnormality In One Or More Part Of Respiratory System OR Abnormality In Central Nervous System OR Injury/Abnormality In Respiratory Muscle And Chest Wall.
2. Alveolar Capillary Membrane Damage.
3. Fluid Into The Interstitial Space OR Into The Alveoli.
4. Imbalance Movement Of Oxygen From The Alveoli To The Pulmonary Capillary Blood.
5. Poorly Ventilation / Hypo-ventilation.
6. Hypoxemia & Hypercapnia.
7. Respiratory Failure

Clinical Manifestation -

Hypoxemia -

1. Restlessness
2. Agitation
3. Dyspnea
4. Disorientation
5. Confusion
6. Delirium
7. Loss Of Consciousness

Hypercapnia -

1. Headache
2. Somnolence
3. Dizziness
4. Confusion 

Other Symptoms -

• Tachypnea
• Bradycardia.

Diagnostic Evaluation -

1. ABG Analysis.
2. Pulse Oximetery
3. Complete Blood Count
4. ECG ( Electrocardiogram )
5. Blood & Sputum Culture.

Management -

1. Administer Oxygen Therapy To Maintain Hypoxemic Condition.
2. Patient Regular Mobilize To Improve Ventilation & Oxygenation.
3. Bronchodilators & Corticosteroids Administer To Reduce Bronchospam & Inflammation.
4. Diuretics To Reduce Pulmonary Edema.
5. Mechanical Ventilation Provide If Needed.
6. Provide Antibiotic For Bacterial Infection & Provide Cardiac Medication.