Diagnosis and Management of Acute Respiratory Failure - Pathofysiology of Acute Respiratory Failure - Hypercapnia

4 important questions on Diagnosis and Management of Acute Respiratory Failure - Pathofysiology of Acute Respiratory Failure - Hypercapnia

Treatment of decreased Vt or respiratory rate

  • Reversal of sedation or drugs
  • Intubation/mechanical ventilation to rest fatigued muscles (myasthenia gravis, Guillan Barré, old age)
  • Respiratory stimulants
  • other causes..

Causes of increased dead space (Vd) (4)

  • Hypovolemia
  • Pulmonary embolism
  • Poor CO
  • Regional airway pressure> regional perfusion pressure = reduced pulmonary blood flow

What is a strategy to reduce dead space in intubated patients?

Reduction in peak or mean airway pressure.
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How can you treat hypercapnia in intubated patients?

Improve Va =   ( vt - vd ) f
Downside of increasing the respiratory rate is hyperinflation ( expiration time is too short )

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