급성호흡부전

1. 정의

1) 호흡부전(respiratory failure) : PaO2 < 50 mmHg or PaCO2 > 50 mmHg.

2) HRF (Type 1; hypoxemic respiratory failure) : PaO2 < 50 mmHg with FiO2 > 0.5

3) HHRF (Type 2; hypoxemic hypercapnic respiratory failure)

2. Mechanism of hypoxia

3. Mechanism of hypercapnia

4. Categories of Respiratory Failure

1) Abnormalities of the CNS

(1) suppression of the neural drive to breath

(2) overdose of narcotic or sedative drug

(3) “structural` CNS abnormalities

(4) metabolic derangement : myxedema, hepatic failure, uremia

(5) obesity-hypoventilation syndrome

2) Abnormalities of peripheral nervous system or chest wall

(1) hypercapnic and hypoxemic respiratory failure

(2) neuromuscular disease

(3) pharmacologic cause

3) Abnormalities of the airway

(1) hypercapnia

(2) upper airway : epiglottitis, aspirated foreign body, tracheal tumor

(3) lower airway : COPD, asthma, cystic fibrosis

4) Abnormalities of the alveoli

(1) hypoxemic respiratory failure

(2) pulmonary edema, diffuse pneumonia, extensive pulmonary hemorrhage

5. 급성 호흡부전의 치료

1) Call for assistance, Note the exact time

2) Air way and breathing (ventilation)

(1) Head dorsiflexion

(2) 기도유지 :

(3) Ventilate with mouth-to-mouth or Bag mask 100% oxygen

(4) 4 quick loading breath, then 12 breath/min (1 breath every 5 compression)

(5) If not intubated, Do not intubate until effective basic life support is ongoing.