VENTILATORY FAILURE MECHANICAL VENTILATION ADAM CZARNY RESPIRATORY FAILURE

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VENTILATORY FAILURE MECHANICAL VENTILATION ADAM CZARNY

VENTILATORY FAILURE MECHANICAL VENTILATION ADAM CZARNY

RESPIRATORY FAILURE

RESPIRATORY FAILURE

RESPIRATORY FAILURE

RESPIRATORY FAILURE

RESPIRATORY FAILURE

RESPIRATORY FAILURE

RESPIRATORY FAILURE occurs when – Pulmonary system is no longer able to meet the

RESPIRATORY FAILURE occurs when – Pulmonary system is no longer able to meet the metabolic demands of the body – Hypoxaemic respiratory failure (p. O 2 <60 mm. Hg) > Fi. O 2 21% – Hypercapnic respiratory failure (p. CO 2 >45 mm. Hg) SYMPTOMS - tachypnoe, short breath - tachycardia - visible use of additional intra- and extrarespiratory muscles - cyanosis

RESPIRATORY FAILURE

RESPIRATORY FAILURE

RESPIRATORY FAILURE OXYGEN IN depends on: – PAO 2 = PIO 2 – (Pa.

RESPIRATORY FAILURE OXYGEN IN depends on: – PAO 2 = PIO 2 – (Pa. CO 2 / 0, 8) • Fi. O 2 • Alveolar pressure PIO 2 = Fi. O 2 x (Patm - PH 2 O) • Ventilation • PACO 2 – Ventilation/perfusion matching (V/Q ratio) – Perfusion – Diffusing capacity CARBON DIOXIDE OUT depends on: - Alveolar ventilation (respiratory rate, tidial volume, dead space)

RESPIRATORY FAILURE VENTILATION / PERFUSION MATCHING Pa. O 2 ↓ Pa. CO 2 N

RESPIRATORY FAILURE VENTILATION / PERFUSION MATCHING Pa. O 2 ↓ Pa. CO 2 N / ↓ Pa. O 2 ↓ Pa. CO 2 ↑

RESPIRATORY FAILURE DEAD SPACE VENTILATION increases in: – Alveolo-capillary barrier damage (emphysema) – Reduced

RESPIRATORY FAILURE DEAD SPACE VENTILATION increases in: – Alveolo-capillary barrier damage (emphysema) – Reduced cardiac output (shock, cardiac arrest, massive pulmonary thrombosis) – Alveoli over-extension (high positive pressure ventilation) SHUNT PERFUSION increases in: – Small airway callapse (asthma) – Alveoli are filled with fluid (pulmonary aedema, inflamation, acute respiratory distress syndrome = ARDS) – Alveli are callaped (atelectasis) – Pulmonary cappilars overflow (pulmonary thrombosis)

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