FEATURES: Pa O2 < 6O mm of Hg Pa Co2 – normal or low (< 50 mm Hg) Hydrogen Ion conc. - normal...
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Transcript of FEATURES: Pa O2 < 6O mm of Hg Pa Co2 – normal or low (< 50 mm Hg) Hydrogen Ion conc. - normal...
![Page 1: FEATURES: Pa O2 < 6O mm of Hg Pa Co2 – normal or low (< 50 mm Hg) Hydrogen Ion conc. - normal Bicarbonate ion conc. - normal.](https://reader036.fdocuments.net/reader036/viewer/2022062322/56649efe5503460f94c12589/html5/thumbnails/1.jpg)
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FEATURES:
Pa O2 < 6O mm of HgPa Co2 – normal or low (< 50 mm Hg)Hydrogen Ion conc. - normalBicarbonate ion conc. - normal
![Page 5: FEATURES: Pa O2 < 6O mm of Hg Pa Co2 – normal or low (< 50 mm Hg) Hydrogen Ion conc. - normal Bicarbonate ion conc. - normal.](https://reader036.fdocuments.net/reader036/viewer/2022062322/56649efe5503460f94c12589/html5/thumbnails/5.jpg)
ACUTE CHRONIC
-Acute asthma - emphysema -pulmonary edema - Lung fibrosis-pneumonia - Lymphangitis carcinomatosa -lobar collapse -Rt to Lt shunts-pneumothorax - Brainstem lesion -pulmonary embolus-ARDS
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Ventilation-perfusion(v/q)mismatch
Presence of low v/q units contributes to hypoxemia
Intracardiac&intrapulmonary shunts
Bypass of deoxygenated blood from alveoli
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FEATURES:
Pa O2 < 60 mm HgPa Co2 > 50 mm HgHydrogen Ion conc. - increasedBicarbonate Ion conc. – increased
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ACUTE CHRONIC
-Acute exacerbation -COPD of COPD-upper airway obst. -sleep apnoea-acute neuropathies/ -kyphoscoliosis paralysis-narcotic drugs -myopathies
-flail chest injury -ankylosing spondylitis
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PaCo2 is dependent on alveolar ventilation Decrease in minute ventilation in neuro-muscular
disorders Increased airway resistance Increase in the volume of dead space
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- Occurs as a result of lung atelectasis- Most common in peri operative period - After gen.anesthesia decrease in functional residual capacity collapse of dependent lung units
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Frequent changes of position Non invasive positive pressure
ventilation Chest physiotherapy Aggressive control of incisional pain
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In shock hypo perfusion of resp. muscles occurs
Up to 40% of CO may be distributed to the resp. muscles
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Dyspnoea
Confusion and somnolence
Restlessness,anxiety,seizures
Asterixes
Cyanosis
Hepatic enlargement,pedaledema
Arrhythmias
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Spirometry Blood Gas analysis: PaO2
PaCo2
Pulse oximetry Acedemia Bicarbonate
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Maintenance of airway Treatment of underlying cause Oxygen therapy physiotherapy Bronchodilators Antibiotics Respiratory stimulants
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100% oxygen cannot be used because, In adults it causes pulmonary oedema
& free radical damage causing fibrosis. premature infants develop retrolental fibroplasia Hence 35-60% O2 (high flow O2) is
used.
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In Type II failure Tolerance to raised Co2 develops Depend on hypoxic drive to breathe lower conc. O2(24-28%) used
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Mechanical ventilation
negative-pressure - iron lung
positive-pressure - Face mask
Nasal prongs
ETT
pressured targeted&volume targeted
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Intubation trauma
Volutrauma
Pneumothorax
Lung infection
Cardiac failure
Weakness of respiratory muscles
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WHEN TO CESSATE MECHANICAL VENTILATION ?
Breathe without ventilator support for 30-120 min.
Resp. rate >35 per min for > 5 min O2 saturation <90% Heart rate > 140 per min Systolic BP < 90 or > 180mm Hg
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