Respiratory failure 31/08/2011 Vivian Ho. Contents Definition Types Pathogenesis Effects Blood gases...
-
Upload
ursula-lewis -
Category
Documents
-
view
221 -
download
2
Transcript of Respiratory failure 31/08/2011 Vivian Ho. Contents Definition Types Pathogenesis Effects Blood gases...
PaO2
40
0.25 0.75 Time (s)
Pathogenesis• Hypoventilation • V/Q inequality• Shunt• Diffusion impairment
NIV• Indications
– Hypercapnic respiratory failure– COPD with resp acidosis pH 7.25-7.35 – Cardiogenic pulmonary oedema– Pneumonia in the immunosuppressed– Weaning from the ventilator in
hypercapnic COPD patients
NIV• Contraindications
– Airway – Facial abn– Respiratory Arrest– Severe hypoxaemia– Untreated pneumothorax– Haemodynamic instability– Agitation– GI bleed / ileus/ surg
Cochrane• NIV vs Medical therapy alone
– Lower mortality NNT 8
– Prevent intubation NNT 5
– Length of stay – Improved pH/paCO2/RR within 1h of
tx
Mechanical Ventilation• Indications for intubation
– Airway– Ventilation – Improve Oxygenation– Decrease work of breathing– Stabilise chest wall in severe injury