https://padlet.com/paulinewong1/59qo5zqfydg3iwu4 NUR5923 Respiratory Pathophysiology en-us 2023-03-08 00:27:14 UTC 2023-05-21 12:06:47 UTC hello@padlet.com paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719610 Cardiogenic acute pulmonary oedema is fluid accumulation in the lungs which impairs gas exchange and lung compliance. Left ventricular failure will cause increase capillary hydrostatic pressure within pulmonary circulation due to back flow. Drawing fluid out of the intravascular space into the interstitial space and the alveoli.

]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719610 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719612 Restrictive as fluid prevents alveoli inflating sufficiently. Fluid also causes decreased compliance of lung tissue. It decreases the total volume of air the alveoli can hold.

]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719612 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719614 Decreases compliance as the alveoli have a harder time expanding and higher chance of collapsing due to high surface tension in the alveoli.]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719614 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719615
In cardiogenic acute pulmonary oedema, adequate perfusion to alveoli but impaired ventilation due to fluid would show a low VQ ratio (less than 0.8).]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719615 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719616 Oxygenation is impaired as oxygen has trouble diffusing from the alveoli to capillaries due to the build up of fluid, causing low SpO2. Alveolar oxygen content (AO2) may be high, however it is unable to move into the capillary space, causing low aO2 (high Aa gradient). Ventilation may be adequate.]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719616 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719617 Initially T1RF due to hypoxia with normal CO2, however can lead to T2RF as the patient becomes fatigued and more unwell due to less expiration of CO2 (hypoxic & hypercapnic).

]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719617 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719618 - pH: initially alkalotic (high pH caused by low CO2 level due to tachypnoea), then acidotic (low pH) due to CO2 retention
- Low Pa02
- Initially low PCO2, then higher
- Bicarbonate: May be normal initially, as the patient becomes acidotic and over days, bicarbonate may increase to compensate]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719618 paulinewong1 https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719620 - dyspnea, worse on exertion & lying down, needing to work harder to adequately ventilate
- Use of accessory muscles 
- Diaphoretic
- Anxious, restless
- Increased RR, compensating to increase oxygen levels
- Decreased SpO2, due to ineffective gas exchange
- Decreased tidal volume, the alveoli has less capacity for air
- Can cause V/Q mismatch, the is inadequate ventilation
- Crackles on auscultation, movement of air over fluid and bubbles
- ECHO - L) sided dysfunction
- CXR - areas of opacity - fluid
- Cyanosis
- Tachycardia
- Hypertension
- Peripheral oedema secondary to R)HF caused by APO]]> 2023-03-08 00:27:14 UTC https://padlet.com/paulinewong1/59qo5zqfydg3iwu4/wish/2507719620