Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Failure in one or both gas exchange functions: oxygenation and carbon dioxide elimination
In practice: PaO2<60mmHg or PaCO2>46mmHg Derangements in ABGs and acid-base status
Alveolar Hypoventilation
PI max Central Hypoventilation Neuromuscular Problem
V/Q abnormality
Nl VCO2 V/Q Abnormality VCO2 Hypermetabolism Overfeeding
Alveolar Hypoventilation
PI max Central Hypoventilation Neuromuscular Problem
V/Q abnormality
Nl VCO2 V/Q Abnormality VCO2 Hypermetabolism Overfeeding
Alveolar Hypoventilation
Alveolar Hypoventilation
PI max Central Hypoventilation Neuromuscular Disorder
V/Q abnormality
Nl VCO2 V/Q Abnormality VCO2 Hypermetabolism Overfeeding
VCO2
V/Q Abnormality
Hypermetabolism Overfeeding
VCO2
V/Q Abnormality Increased dead space ventilation advanced emphysema PaCO2 when Vd/Vt >0.5 Late feature of shunt-type edema, infiltrates
Hypermetabolism Overfeeding
VCO2
V/Q Abnormality
Hypermetabolism Overfeeding
VCO2 only an issue in pts with ltd ability to eliminate CO2 Overfeeding with carbohydrates generates more CO2
No
Hypoventilation
(PAO2 - PaO2) Hypovent plus another mechanism
(PAO2 - PaO2)?
Yes Is low PO2 correctable with O2? No Shunt Yes V/Q mismatch No Inspired PO2 High altitude FIO2
No
Hypoventilation
(PAO2 - PaO2) Hypovent plus another mechanism
(PAO2 - PaO2)?
Yes Is low PO2 correctable with O2? No Shunt Yes V/Q mismatch No Inspired PO2 High altitude FIO2
V/Q mismatch
SHUNT V/Q = 0
SHUNT V/Q = 0
Severe ALI B/L radiographic infiltrates PaO2/FiO2 <200mmHg (ALI 201-300mmHg) No e/o L Atrial P; PCWP<18
Neutrophils - ROIs and proteases damage capillary endothelium and alveolar epithelium
Neutrophils - ROIs and proteases damage capillary endothelium and alveolar epithelium Fluid in interstitium and alveoli
Neutrophils - ROIs and proteases damage capillary endothelium and alveolar epithelium Fluid in interstitium and alveoli
Impaired gas exchange Compliance PAP
Exudative phase
Diffuse alveolar damage
Proliferative phase
Fibrotic phase
31% mortality v 39.8% 65.7% breathing without assistance by day 28 v 55% Significantly more ventilator-free days Significantly more days without failure of nonpulmonary organs/systems