Internal Medicine

P1: SBT

0521779407-02 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:18

58 Acute Respiratory Alkalosis Acute Respiratory Failure/Monitoring

■Other causes – no specific treatment – use disorder as a sign to help

identify underlying illness (e.g., gram-negative sepsis, pulmonary

embolism

follow-up

■Counseling for anxiety-hyperventilation, other causes, appropriate

follow-up as needed

complications and prognosis

■Excellent if cause reversible

Acute Respiratory Failure/Monitoring......................

THOMAS SHAUGHNESSY, MD

history & physical

Risk Factors

■Hypercapnea – Ventilation Failure

■Hypoxia – Oxygenation Failure

■Impaired consciousness -Airway compromise

■Hypersecretion – Impaired secretion clearance

■Cardiac – CHF, pulmonary edema

■Pulmonary – Infection, Obstructive and/or Restrictive Disease

■CNS – Stroke, Infection, Acute/Chronic Neuropathy, Encephalopathy

■Inadequate Secretion Clearance – Malnutrition, CF, bronchitis

Signs and Symptoms

■Tachypnea, tachycardia, dyspnea, diaphoresis, altered mental sta-

tus, use of accessory muscles of respiration (SCM, diaphragm, inter-

costals)

tests

■Acute Respiratory Failure is predominately diagnosed by clinical

observations

Laboratory

Basic Studies

■ABGs:

➣Suggestive of impending resp failure:

pH: <7.25

PaO 2 <60

PaCO 2 above baseline with pH <7.30

■Sustained Minute Ventilation >15 l/min, RR >30