ACUTE RESPIRATORY FAILURE

(ARF)

By Inst :
Baraa zaghal Mahdia alkony
haneen amer
WHAT IS ACUTE RESPIRATORY FAILURE?
 Acute respiratory failure occurs when fluid builds
up in the air sacs in your lungs:
 Failure
 Oxygenation
 Ventilation
 Both of the above

 Altered gas exchange (room air)

 PaO2 < 60 mm Hg
 PaCO2 > 50 mm Hg
 pH ≤ 7.30
TYPES OF ACUTE RESPIRATORY FAILURE

 The two types :

 hypoxemic :respiratory failure means that you

don’t have enough oxygen in your blood
 hypercapnic :respiratory failure means that there’s too
much carbon dioxide in your blood(co2), Alveolar
hypoventilation—decrease in ventilation and hypoxemia
SYMPTOMS OF ACUTE RESPIRATORY
FAILURE

 People with a high carbon dioxide level may

experience:
 rapid breathing

 confusion

 People with low oxygen levels may experience:

 an inability to breathe

 bluish coloration in the skin, fingertips, or lips

ONTHER SYMPTOMES WILL BE SEINE WITH
ARF

 restlessness
 anxiety

 sleepiness

 loss of consciousness

 rapid and shallow breathing

 racing heart

 irregular heartbeats (arrhythmias)

 profuse sweating
CAUSES ACUTE RESPIRATORY FAILURE

 Acute respiratory failure has several different

causes:
 Obstruction

 Injury

 Drug or alcohol abuse

 Chemical inhalation

 Stroke

 Infection
OBSTRUCTION
 When something lodges in your throat, you may
have trouble getting enough oxygen into your
lungs. Obstruction can also occur in people with
chronic obstructive pulmonary disease (COPD) or
asthma when an exacerbation causes the airways
to become narrow.
INJURY
 An injury that impairs or compromises your
respiratory system can adversely affect the
amount of oxygen in your blood. For instance, an
injury to the spinal cord or brain can
immediately affect your breathing. The brain
tells the lungs to breathe. If the brain can’t relay
messages due to injury or damage, the lungs
can’t continue to function properly.
DRUG OR ALCOHOL ABUSE
 If you overdose on drugs or drink too much
alcohol, you can impair brain function and hinder
your ability to breathe in or exhale.
CHEMICAL INHALATION
 Inhaling toxic chemicals, smoke, or fumes can
also cause acute respiratory failure. These
chemicals may injure or damage the tissues of
your lungs, including the air sacs and capillaries.
STROKE
 A stroke occurs when your brain experiences
tissue death or damage on one or both sides of
the brain. Often, it affects only one side.
Although stroke does present some warning
signs, such as slurred speech or confusion, it
typically occurs quickly. If you have a stroke, you
may lose your ability to breathe properly.
INFECTION
 Infections are a common cause of respiratory
distress. Pneumonia in particular, may cause
respiratory failure, even in the absence of ARDS.
According to the Mayo Clinic, in some cases
pneumonia affects all five lobes of the lungs.
FAILURE OF VENTILATION
 Hypercapnia
 Related to:

 Alveolar hypoventilation—decrease in
ventilation and hypoxemia
 V/Q mismatch
ASSESSMENT OF RESPIRATORY FAILURE
 Neurological—shows earliest signs of hypoxemia
and hypercapnia
 Respiratory
 Cardiovascular
 Nutrition

 Psychosocial
 Chest x-ray
 Pulmonary function tests
 Laboratory studies
 Arterial blood gases (ABGs)
 Pulse oximetry and end-tidal CO2
NURSING DIAGNOSES
 Infection

 Anxiety

 Impaired skin integrity

 Altered nutrition
NURSING DIAGNOSES
 Ineffective breathing pattern:
Defined as "Inspiration and/or expiration that does
not provide adequate ventilation"

 Impaired gas exchange

Defined as excess or deficit in oxygenation and/or
carbon dioxide elimination at the alveolocapillary
membrane.
 Fluid volume excess:

Hypervolemia.
NURSING INTERVENTIONS
 Maintain a patent airway
 Optimize O2 delivery

 Minimize O2 demand

 Identify and treat the cause of ARF

 Prevent complications
MEDICAL MANAGEMENT
 Oxygen
 Bronchodilators

 Corticosteroids

 Sedation

 Transfusions

 Therapeutic paralysis

 Nutritional support

 Hemodynamic monitoring