19 Respiratory failure Arsalan Radman

1. PREPARED BY Dr Arsalan
Radman

2. Defination
Etiology
Pathophysiology
Sign and symptom
Diagnosis
Treatment

3. Respiratory failure is a syndrome that
developed when the respiratory system is
unable to maintain oxygenation or
ventilatilation
Respiratory failure can be acute or chronic
hypoxemic or hyper capnic or mixed type

4. Acute respiratory failure occur whithen
minute to hours of an inciting incident
Chronic respiratory failure occur over
month to years often due to chronic lung
disease

5. Most common form of respiratory failure
Result from a decrease ability to
oxygenate the blood

6. Result from a decrease ability to eliminate
carbon dioxide
Decrese pH of the blood cause respiratory
acidosis

7. Etiology of type 1 RF
Right to Left shunt
Pulmonary edema
Pneumonia pulmonary hemorrhage
Aspiration
Atelactasis
ARDS

8. V/Q mismatch
Pulmonary embolism
Asthma
COPD
Cystic fibrosis
ILD
Pulmonary hypertention

9. Low inspirated oxygen
High altitude
Hypoventilation ;
Sedative medication
Neuromuscular condition

10. Diminished respiratory drive ;
Sedative medication
Brain stem lesion that affect central
respiratory center
Multiple sclerosis
Hypothermia

11. Impired respiratory muscle function
GBS
Myasthena gravis
ALS
Botulism
Tetanus
Myopathy and fatigue

12. Airway obstruction
COPD
Asthma
Obstructive sleep apnea
Cystic fibrosis

13. Diminished lung compliance
Alveolar edema
Pneumonia
Atelactasis
ARDS

14. Diminished chest wall eiasticity
Pleural effusion
Obesity
Kyphoscoliosis
Abdominal distention
Pneumothorax

15. RHIGHT TO LEFT SHUNT
Blood is shunting from right side of the
heart to left side without undergoing
oxygenation
Deoxygenated blood mix with oxygenated
blood cause decrese Po2
This is caused by
Cardiac shunting from congenital heart
disease

16. Pulmonary shunting that cause fluid fill the
alveoli and preventing oxygen perfusion
100% oxygen administration will not
change oxygenation

17. Low v/q mismatch
Diminished oxygen entery into alveoli with
normal blood flow
Overperfussion of alveoli with normal
ventilation
Result in
Hypoxemia
Hypercapnia

18. High v/q
Result from blood flow in to alveli with
normal ventilation
Ventelation is wasted
Must be served for gas exchang
100 % oxegen can correct oxygenation

19. Tachypnea cyanosis
Tachycardia headache
Low oxygen saturation asterixis
Somnolence
Dyspnea
Diaphoresis
Alter mentantal state
Use af accessory muscle

20. ABG
Hypoxemic type
Pao2 <60 mmhg
Sao2 <90%
Hypercapnic type
Paco2 >50mmhg
Decrease pH 7.3

21. Onc ee hypoxemic respiratory failure
established
Normal 5-10mmhg
Increase in etiology that cause
Right to left shunt
v/Q mismatch

22. CBC
POLYCYTHEMIA
LEUKOCYTOSIS
INCREASE TROPONIN
BLOOD SPUTUM CULTURE
URINE DRUG ANALYSIS
PFT
CXR
CT SCAN

23. Oxygen
NPPV
MV
EXTRACOPORAL MEMBRANE
OXYGENATION

24.  THANK YOU