Acute respiratory failure and acute respiratory distress syndrome
Advanced Thoracic Surgery, Akademisyen Kitabevi, ss.87-92, 2021
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2021
- Yayınevi: Akademisyen Kitabevi
- Sayfa Sayıları: ss.87-92
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Acute respiratory failure and acute respiratory distress syndrome (ARDS) are clinical conditions in which the respiratory system is unable to maintain gas exchange. Respiratory failure occurs when PaO2 is below 60 mmHg and/or PaCO2 is above 50 mmHg. Respiratory failure is classified into type 1 and type 2 based on abnormalities in blood gases. Type 1 (hypoxemic) respiratory failure occurs when PaO2 is <60 mmHg with normal or subnormal PaCO2. Gas exchange is impaired at the alveolar-capillary membrane level in this type of respiratory failure. Examples of type 1 respiratory failure include cardiogenic or non-cardiogenic pulmonary edema and severe pneumonia. Type 2 (hypercapnic) respiratory failure occurs when PaCO2 is >50 mmHg. Hypoxemia is common and is due to respiratory pump failure. Additionally, respiratory failure is classified as acute or chronic based on its onset, course, and duration. Acute respiratory distress syndrome (ARDS) was first defined in 1967 and is associated with several clinical abnormalities such as acute hypoxemia, non-cardiogenic pulmonary edema, decreased lung compliance, increased work of breathing, and the need for positive pressure ventilation. The diagnosis of ARDS is based solely on clinical criteria as direct measurements of lung injury with pathological samples are not practical in most patients. ARDS often occurs due to various causes such as pneumonia, non-pulmonary sepsis, aspiration of gastric and/or oral and esophageal contents, and severe trauma. The incidence and etiology of ARDS vary depending on geographical location and the available healthcare systems. Effective pharmacological treatments for ARDS have not yet been identified. Several comorbidities and exposures are associated with increased susceptibility to ARDS, including alcohol abuse, smoking, air pollution, and hypoalbuminemia. The mortality rate associated with ARDS is higher in males than females.