Respiratory Support

• What are the options for supporting a patient’s respiratory system from least to most invasive?

  Oxygen therapy, high-flow nasal cannula, non-invasive ventilation, intubation and mechanical ventilation, ECMO
• What is the purpose of respiratory support?

  It buys time while the underlying problem is managed.
• What is Acute Respiratory Distress Syndrome (ARDS) often secondary to?

  Severe inflammatory reaction in the lungs, often due to sepsis, pneumonia, or trauma.
• What are the clinical features of ARDS?

  Acute respiratory distress, hypoxia with inadequate response to oxygen therapy, and bilateral infiltrates on chest x-ray.
• What is the management approach for ARDS?

  Supportive care including respiratory support, prone positioning, and careful fluid management.
• Why is lung protective ventilation important in ARDS management?

  To avoid over-inflating the small functional portion of the lungs.
• What is the role of Positive End-Expiratory Pressure (PEEP) in respiratory support?

  PEEP prevents the lungs from collapsing further and improves ventilation.
• What are the benefits of prone positioning in ARDS management?

  Reduces lung compression, improves blood flow, enhances secretion clearance, and improves oxygenation.
• What is the FiO2 range for nasal cannula oxygen delivery?

  24% to 44% oxygen.
• What is the approximate FiO2 for a simple face mask at 5 L/min?

  40% oxygen.
• What is the purpose of Venturi masks?

  To deliver exact concentrations of oxygen.
• Why is Positive End-Expiratory Pressure (PEEP) important in respiratory care?

  It helps keep the airways from collapsing and improves ventilation.
• What is the function of a high-flow nasal cannula?

  It allows for controlled flow rates of up to 60 L/min of humidified and warmed oxygen.
• What is Continuous Positive Airway Pressure (CPAP) used for?

  To maintain the patient’s airways in conditions where they are likely to collapse.
• How does Non-Invasive Ventilation (NIV) work?

  It uses a mask to blow air forcefully into the lungs to ventilate them.
• What does BiPAP stand for?

  Bilevel Positive Airway Pressure.
• What is the purpose of mechanical ventilation?

  To move air into and out of the lungs when other forms of support are inadequate.
• What is required to connect a ventilator to the lungs?

  An endotracheal tube (ETT) or tracheostomy.
• What are the basic settings used for mechanical ventilation?

  FiO2, respiratory rate, tidal volume, inspiratory:expiratory ratio, peak flow rate, and peak inspiratory pressure.
• What is Extracorporeal Membrane Oxygenation (ECMO)?


  The most extreme form of respiratory support where blood is oxygenated outside the body.
• When is ECMO used?

  In short-term situations where there is a potentially reversible cause of respiratory failure.
• Where is ECMO provided?

  In specialist ECMO centres.
• What are the key components of respiratory support management?

  • Oxygen therapy
  • High-flow nasal cannula
  • Non-invasive ventilation
  • Intubation and mechanical ventilation
  • Extracorporeal membrane oxygenation (ECMO)
  • Chest physiotherapy
  • Suction to clear secretions
• What are the clinical features and management strategies for Acute Respiratory Distress Syndrome (ARDS)?

  Clinical features:

  • Acute respiratory distress
  • Hypoxia with inadequate response to oxygen therapy
  • Bilateral infiltrates on chest x-ray

  
  

  Management strategies:

  • Supportive care
  • Respiratory support
  • Prone positioning
  • Careful fluid management
• What are the methods of oxygen delivery and their approximate FiO2 levels?

  • Nasal cannula: 24-44%
  • Simple face mask: 40-60%
  • Venturi masks: 24-60%
  • Non-rebreather mask: 60-95%
• What are the basic settings and modes of mechanical ventilation?

  Basic settings:

  • FiO2
  • Respiratory rate
  • Tidal volume
  • Inspiratory:expiratory ratio
  • Peak flow rate
  • Peak inspiratory pressure

  
  

  Modes:

  • Volume-controlled ventilation
  • Pressure-controlled ventilation
  • Assist control
  • Continuous positive airway pressure (CPAP)
• What are the indications and limitations of Extracorporeal Membrane Oxygenation (ECMO)?

  Indications:

  • Severe respiratory failure
  • Potentially reversible causes

  
  

  Limitations:

  • Short-term use only
  • Requires specialist ECMO centres