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Emergency Medicine Block: Respiratory Failure

This document discusses respiratory failure, which occurs when inadequate oxygenation or carbon dioxide removal results in hypoxemia or hypercapnia. Respiratory failure has various etiologies related to the central nervous system, peripheral nervous system, chest wall, airways, or alveoli. It can be classified as hypoxemic or hypercapnic. Management involves blood gas analysis, airway management, correcting hypoxemia and hypercapnia, monitoring the patient, and searching for underlying causes. Outcomes depend on the type and severity of respiratory failure as well as patient characteristics and complications.

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Ronald Chrisbianto
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200 views19 pages

Emergency Medicine Block: Respiratory Failure

This document discusses respiratory failure, which occurs when inadequate oxygenation or carbon dioxide removal results in hypoxemia or hypercapnia. Respiratory failure has various etiologies related to the central nervous system, peripheral nervous system, chest wall, airways, or alveoli. It can be classified as hypoxemic or hypercapnic. Management involves blood gas analysis, airway management, correcting hypoxemia and hypercapnia, monitoring the patient, and searching for underlying causes. Outcomes depend on the type and severity of respiratory failure as well as patient characteristics and complications.

Uploaded by

Ronald Chrisbianto
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Ronald Chrisbianto Gani

405090223
Faculty of Medicine
Tarumanagara University
EMERGENCY MEDICINE BLOCK
RESPIRATORY FAILURE
RESPIRATORY FAILURE
RESPIRATORY FAILURE
Inadequate blood oxygenation or cabon
dioxide removal
Classified as
Hypercapnic Respiratory Failure
Hypoxemic Respiratory Failure
Fishmans Pulmonary Diseases & Disorders 4th Ed
ETIOLOGY
Central nervous system
Sedative/narcotic overdose
Meningoencephalitis
Tumirs or vascular
abnormalities of medulla
Strokes
Severe myxedema
Hepatic failure
Advanced Uremia
Obesity-hypoventilation
syndrome
Perpipheral Nervous
system or Chest Wall
GBS
Mysathenia Gravis
Polymiositis
Muscular dystrophies
Acute Poliomyelitis
Traumatic Spinal Cord
Injury
Severe kyphoscoliosis
Flail chest, morbid obesity
Fishmans Pulmonary Diseases & Disorders 4th Ed
ETIOLOGY
Airways
Epiglotitis
Foreign body aspiration
Tracheal tumor
COPD
Asthma
Advanced cystic fibrosis

Alveoli
Pulmonary edema
Diffuse pneumonia
Pulmonary hemmorhage
Aspiration of stomach
contents
Near-drowning
Fishmans Pulmonary Diseases & Disorders 4th Ed
CLASSIFICATION
Fishmans Pulmonary Diseases & Disorders 4th Ed
PATHOPHYSIOLOGY
Fishmans Pulmonary Diseases & Disorders 4th Ed
PATHOPHYSIOLOGY
Fishmans Pulmonary Diseases & Disorders 4th Ed

Fishmans Pulmonary Diseases & Disorders 4th Ed

Fishmans Pulmonary Diseases & Disorders 4th Ed
MANAGEMENT
Blood gas analysis for confirmation
Triage, based on
Acuity of the respiratory failure
Degree of hypoxemia, hypercapnia, acidemia
Presence of co-morbidities (cardiac/renal disease)
Airway Management
Emergency intubation or ventilator depends on
clinical condition and arterial blood gas test
Fishmans Pulmonary Diseases & Disorders 4th Ed
MANAGEMENT
Correction of Hypoxemia and Hypercapnia
Hypoxemia correction to PaO2 60mmHg,
higher in patients with coronary or CVD
May use face mask or Venturi Mask (high flow O2)
May require intubation or ventilator
Search for underlying cause
Fishmans Pulmonary Diseases & Disorders 4th Ed
MANAGEMENT
Monitoring
Acute : RR, tidal volume, use of accessory muscles,
paradoxical breathing movement
Mechanical ventilation related complications
Status asthmaticus hypotension due to intrinsic
PEEP alter ventilator, implement sedation or
paralytic agents


Fishmans Pulmonary Diseases & Disorders 4th Ed
Fishmans Pulmonary Diseases & Disorders 4th Ed
COMPLICATIONS
Fishmans Pulmonary Diseases & Disorders 4th Ed
Fishmans Pulmonary Diseases & Disorders 4th Ed
PROGNOSIS
Acute hypoxemic respiratory failure
Survival rate 60%
Worse outcomes in old patients and patients with
pre-existing lung disease
2/3 survivors impaired pulmonary function
Fishmans Pulmonary Diseases & Disorders 4th Ed
PROGNOSIS
Acute hypercapnic respiratory failure
Mortality depends on
Patient physiological reserve (cardiac, renal, hepatic
status, patients age)
Underlying causes
Severity of respiratory failure (pH and PCO2)
Complications after onset (sepsis, pneumonia, GI bleed)
Cachexia and hime confinement poor outcome
Fishmans Pulmonary Diseases & Disorders 4th Ed
REFERENCES
Fishman AP, Elias JA, Fishman JA, Grippi MA,
editors. Fishmans Pulmonary Diseases and
Disorders. 4th Ed. New York : McGraw-Hill,
2008
Marx JA, Hockberger RS, Walls RM, Adams JG,
editors. Rosens Emergency Medicine
Concepts and Clinical Practice. 7th Ed.
Philadelpia : Mosby Elsevier, 2010

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