Respiratory Failure

 is the inability if the cardiovascular and pulmonary

systems to maintain an adequate exchange of oxygen
and carbon dioxide in the lungs.
 Is a condition in which the level of oxygen in the blood
becomes dangerously low or the level of carbon dioxide
becomes dangerously high.
Acute Respiratory Failure
 is a sudden inability of the lungs to maintain normal
respiratory function.

Causes: either caused by a failure in oxygenation or in

ventilation.

Pathophysiology:

 In the pathophysiology there is an increase of carbon

dioxide level and decrease of oxygen level in the blood

Two (2) mechanisms are involved:

I.Hypercapnic Ventilatory Failure

a. Alveolar hypoventilation- decrease oxygen supply and

decrease carbon dioxide is removed.( e.g. anxiety,
increase work of breathing ).

b. Ventilation-Perfusion mismatch or V/Q imbalance- too

little ventilation with normal blood flow or too little
blood flow with normal ventilation.
Decrease in PaO2 level hypoxemia
S/Sx:
- restlessness
- cheyne-stokes respiration
 - increase in BP
- tachycardia
- apnea,coma
II. Mechanisms of Hypoxemic Respiratory Failure
> PaO2 <50-60 mmHg can contribute to the
development of hypoxia or lack of tissue oxygen.

a. Alveolar hypoventilation
b. V/Q imbalance

c. Shunts- is the extra ventilation-perfusion disturbance.

There is perfusion but no ventilation at all or ventilaton
in the absence of perfusion.

d. Diffusion abnormalities
Three (3) underlying reasons:
1. The contact time for the RBC at the capillary
membrane is decreased.
2. There is a reduction of pulmonary capillary blood
secondary to obstruction or destruction of
vessels.
3. There is thickened blood – gas membrane or
alveolar capillary membrane/ alveolar capillary
block

Hypoxemia - is a reduced oxygenation of the arterial blood,

evidenced by reduced PaO2 of arterial blood gases.

Hypoxia – is diminished tissue oxygenation at the cellular

level that may be caused by conditions affecting other body
systems.
Clinical manifestations:
Respiartory
 Dyspnea
 Tachypnea
 Cyanosis
 Adventitious breath sounds; crackles, wheezing
CNS
 Anxiety
 Confusion
 Restlessness
 Headache
 Loss of concentration
Cardiovascular
 Tachycardia
 Increase CO

Labs and Diagnostic studies may reveal:

ABGs: PaCO2 < 60 mmHg; PaCO2 .> 50 mmHg; pH < 7.35
ECG: cardiac dysrhytmias.

Collaborative and Nursing Care Management.

1.Maintain a patent airway- effective coughing,
suctioning,positioning.