The respiratory system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Respiratory failure is a condition that results when the lungs are no longer able to sufficiently oxygenate the blood or remove CO2 from it. It may occur as the end result of chronic respiratory diseases or it may be an acute event caused by factors such as pneumothorax or opioid drug overdose (see Table 8.16). Respiratory failure may be classified as being mainly hypercapnic or hypoxemic in terms of presentation. Hypercapnic failure is associated with excess levels of CO2 and occurs when there is inadequate alveolar ventilation (e.g., depression of the respiratory centers). Hypoxemic failure occurs when there is inadequate exchange of oxygen between the alveoli and their associated capillaries (e.g., severe COPD). However, most patients with respiratory failure exhibit a combined presentation of hypercapnia and hypoxemia.
Life Care Planning for Spinal Cord Injury
Roger O. Weed, Debra E. Berens in Life Care Planning and Case Management Handbook, 2018
Respiratory failure is caused by either failure to ventilate, which is characterized by increased levels of carbon dioxide in the blood, or failure to oxygenate, in which there is reduced oxygen content within the blood. Global alveolar hypoventilation (GAH) is an insidious condition characterized by the gradual loss of pulmonary function as a result of reduced compliance from chronic hypoventilation. Its effects can be accentuated by comorbid scoliosis, kyphosis, and obesity. Individuals with vital capacities below 5 to 10 mL/kg are considered to be at highest risk for respiratory failure and may require assisted ventilation to support life. Other factors that can contribute to impaired respiratory status include pregnancy, scoliosis, spasticity, and syringomyelia.
Anesthesia
Prem Puri in Newborn Surgery, 2017
The anesthetist should make a brief appraisal of the infant’s overall condition and follow this with a careful assessment of individual body systems. The neonate’s weight should be recorded accurately. Overhydration or hypovolemia can be detected by assessment of skin turgor, the anterior fontanelle, and liver size. Peripheral vasoconstriction may indicate either hypovolemia or acidosis. Signs of respiratory failure include nasal flaring, tachypnea, chest wall recession, grunting respiration, or apneic spells. Airway anatomy should be carefully assessed in order that potential difficulties with endotracheal intubation can be anticipated. One should look for other associated congenital anomalies in the surgical neonate. This is particularly so when examining the cardiovascular system (e.g., one-third of infants with esophageal atresia also have some form of congenital heart disease). Accurate preoperative neurological assessment is mandatory in infants presenting for anesthesia for neurosurgery. Finally, potential difficult intravenous (i.v.) access and the possible need for central access for inotropes or postoperative total parenteral nutrition should be evaluated.
Diagnostic and therapeutic approach to upper gastrointestinal bleeding
Published in Paediatrics and International Child Health, 2019
In view of an increased risk of pneumonia and Clostridium difficile infection with aggressive acid suppression, stress ulcer prophylaxis is recommended in a select group of children admitted to PICU who are at risk of developing clinically significant UGI bleeding. The risk of clinically significant UGI bleeding is associated with two or more of the following risk factors: (a) respiratory failure, (b) coagulopathy (prolonged prothrombin time, partial thromboplastin time and platelet counts <50 × 109/L) and children with a PRISM score >10 [5]. PPIs were found to be more effective than histamine 2 receptor antagonists in preventing clinically significant UGI bleeding with no difference in the risk of pneumonia, death or ICU length of stay [29]. The dose of PPI is 1 mg/kg once daily [30].
Assessing diagnosis and managing respiratory and cardiac complications of sarcoglycanopathy
Published in Expert Opinion on Orphan Drugs, 2020
Corrado Angelini, Valentina Pegoraro
In a large series of 439 patients [16] from 13 different countries, most sarcoglycanopathy patients present respiratory involvement of variable severity, which is especially relevant in the advanced stage of the disease [3] that sometimes results in respiratory failure while patients are still ambulant. Symptoms caused by the respiratory failure may be specific, such as breathlessness, or more general, such as fatigue, lethargy, poor appetite, weight loss, and impaired concentration. Patients may describe breathlessness at rest or during exertion, depending on the severity of the muscle weakness. With the association of the diaphragm weakness, symptoms of orthopnea or breathlessness may be apparent when bending over. Experiencing breathlessness when a patient is immersed in water above the waist, for example, when entering a swimming pool, is a classical symptom of diaphragm weakness.
Current status of lung cancer in Spain: a retrospective analysis of patient characteristics, use of healthcare resources and in-hospital mortality
Published in Current Medical Research and Opinion, 2020
The principal diagnosis upon hospitalization (admission motive) was in all cases a lung carcinoma, and secondary diagnoses were utilised to perform an analysis of relevant comorbid conditions at the hospital level. Metastatic or secondary malignant neoplasms were registered in 76.66% of patients with a lung carcinoma (Table 3). The second most repeated comorbidity was hypertension, found in 33.57% of patients. A history of tobacco use appeared in 25.29% of patients. Respiratory symptoms were common among these patients, as respiratory failure and bronchitis, likely to be symptoms of the disease. Chronic obstructive pulmonary disease (COPD) was registered in 12.19% of all patients. Other registered comorbidities were disorders of lipoid metabolism and diabetes mellitus, diagnosed in 23.02% and 21.39% of patients respectively.
Related Knowledge Centers
- Brain Ischemia
- Carbon Dioxide
- Gas Exchange
- Hypoxemia
- Partial Pressure
- Heart
- Respiratory System
- Hypercapnia
- Thrombosis
- Blood Gas Tension