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Swatilekha Das, profile picture
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Acute Respiratory Failure

Respiratory failure is characterized by inadequate gas exchange, defined as a PaO2 less than 60 mmHg and a PaCO2 greater than 50 mmHg, with various causes including pneumonia and pulmonary embolism. Treatment options focus on correcting hypoxemia and abnormal pH levels, often involving oxygen therapy, bronchodilators, and mechanical ventilation. Diagnostic measures include ABG analysis, chest radiography, and bronchoscopy to identify underlying conditions and monitor respiratory function.

Healthcare◦
Related topics:
Respiratory Disease•
SWATILEKHA DAS RN, BSN, MSN
 Respiratory failure is a syndrome in which the respiratory system fails in one or both of its gas exchange functions. That is oxygenation and carbon dioxide elimination.  In practice, respiratory failure is definedas: -PaO2 valueof less than 6o mmHg while breathing air -PaCO2 of more than 50 mmHg
 Acute exacerbation of asthma  Pulmonaryembolism  Acute respiratory distresssyndrome  Pneumonia  Pulmonary trauma  Inhalation injury (with toxic fumes or gases including chlorine, smoke, carbon monoxide, hydrogensulfide)
CAUSES
 Type I or Hypoxemic (PaO2 <60 mmHg): Failureof oxygenexchange  Type II or Hypercapnic (PaCO2 >45 mmHG): Failureto exchange or remove carbondioxide  Type III Respiratory Failure: Perioperative Respiratory Failure  Type IV Respiratory Failure: Shock
 Tachycardia  Impaired functioning of the heart and bloodvessels  Inadequate blood circulation to the parts of the body  Appears sleepy andconfused
 Cyanosis  Drowsiness and malfunctioning of the brain andheart  Lethargy and shortness of breath  Impaired mental functioning
 Pneumonia: -cough -sputum production -chest pain
 ABG  COMPLETE BLOOD COUNT  MICROBIOLOGY  Respiratory cultures: sputum/trachealaspirate  Blood, urine, body fluid (e.g. pleural)cultures
 PULMONARY FUNCTION TEST/BEDSIDE SPIROMETRY  Identify obstruction, restriction  May be difficultto perform if critically ill  BRONCHOSCOPY  Obtain biopsies  Bronchoscopy may not be safe in thecritically ill
 CHEST RADIOGRAPHY  Identifychest wall, pleural and lung parenchymal with opacities present  ELECTROCARDIOGRAM  Identify arrythmias, ischemia, ventricular dysfunction  ECHOCARDIOGRAM  Identify rightand leftventriculardysfunction
TREATMENT Correction of hypoxemia- • Oxygen therapy with bronchodilators • Steroids • antibiotics
CORRECTION OF ABNORMAL PH LEVEL • IV Sodium bicarbonate may be used conservatively and usually only when the patient is mechanically ventilated. • PH >7.45 may be managed by placing a rebreathing mask on the patient .
INTUBATION AND MECHANICAL VENTILATION • It is done to restore alveolar function, restore PH level within normal limits and decrease work of breathing . • Early intubation can prevent further airway collapse and tissue injury.
ENDOTRACHEAL INTUBATION
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