Pulmonology
Dyspnea & respiratory failure
Dyspnea and respiratory failure are among the most common and life-threatening conditions encountered in critical care. Prompt recognition, assessment, and management of these conditions are essential for improving patient outcomes and preventing deterioration.
This section covers:
- Dyspnea, a subjective sensation of breathlessness with a broad differential diagnosis, requiring a systematic approach to identify the underlying cause and initiate appropriate treatment.
- Respiratory failure, classified as hypoxemic (type I) or hypercapnic (type II), often necessitating oxygen therapy, noninvasive ventilation (NIV), or mechanical ventilation depending on severity.
- Recent advancements in respiratory failure management, including high-flow nasal cannula (HFNC), extracorporeal carbon dioxide removal (ECCO₂R), and evolving mechanical ventilation strategies.
- Respiratory muscle disorders, which can contribute to or complicate respiratory failure, requiring specialized diagnostic and therapeutic approaches.
By integrating evidence-based knowledge, emerging therapies, and best practices, this section equips healthcare professionals with the tools to diagnose and manage dyspnea and respiratory failure effectively in acute and critical care settings.
Dyspnea
Acute dyspnea
Approach to Adult Patients with Acute Dyspnea
Elizabeth DeVos et al., Emergency Medicine Clinics of North America (2016)
What’s inside
This article provides a comprehensive approach to evaluating adult patients presenting with acute dyspnea in the emergency department. It emphasizes the importance of a thorough history, physical examination, and understanding of pathophysiology to guide diagnostic testing and treatment decisions.
Why it’s relevant
Acute dyspnea is a common and potentially life-threatening symptom that requires prompt and accurate assessment to determine its underlying cause and initiate appropriate management.
Key focus
- Systematic evaluation of patients with undifferentiated respiratory distress.
- Differential diagnosis of dyspnea, including obstructive, parenchymal, circulatory, and compensatory causes.
- Guidance on history-taking and physical examination techniques specific to dyspneic patients.
- Recommendations for diagnostic testing based on clinical findings.
Takeaway
A structured approach to the assessment of acute dyspnea enhances the clinician's ability to rapidly identify the underlying etiology, facilitating timely and effective treatment in emergency settings.
Respiratory failure
Acute respiratory failure
Respiratory failure
C. Roussos et al., European Respiratory Journal (2003)
What’s inside
This comprehensive review delves into the pathophysiology, clinical manifestations, and management strategies of respiratory failure, providing an in-depth understanding of the condition's underlying mechanisms and therapeutic approaches.
Why it’s relevant
Respiratory failure is a critical condition encountered across various medical settings. A thorough grasp of its pathophysiology and management is essential for healthcare professionals to effectively diagnose and treat affected patients.
Key focus
- Detailed exploration of the mechanisms leading to respiratory failure, including impairments in gas exchange and respiratory muscle function.
- Clinical features and diagnostic criteria essential for identifying respiratory failure in patients.
- Comprehensive overview of management strategies, encompassing both non-invasive and invasive interventions.
- Discussion on the role of mechanical ventilation and adjunctive therapies in the treatment of respiratory failure.
Takeaway
A deep understanding of the complex mechanisms and clinical aspects of respiratory failure is crucial for implementing effective management strategies, ultimately improving patient outcomes in critical care settings.
Acute respiratory failure
Highlights in acute respiratory failure
Raffaele Scala et al., European Respiratory Review (2018)
What’s inside
This article provides an overview of recent advancements in the management of acute respiratory failure (ARF), focusing on both hypoxemic and hypercapnic forms. It discusses the evolving strategies in noninvasive ventilation (NIV), high-flow nasal cannula (HFNC) therapy, and extracorporeal carbon dioxide removal (ECCO₂R).
Why it’s relevant
Acute respiratory failure remains a significant cause of morbidity and mortality in critical care settings. Staying informed about the latest therapeutic approaches is essential for healthcare professionals to enhance patient outcomes.
Key focus
- Advancements in noninvasive ventilation techniques and their application in ARF management.
- The role of high-flow nasal cannula therapy in treating hypoxemic respiratory failure.
- Emerging use of extracorporeal carbon dioxide removal in managing hypercapnic respiratory failure.
- Challenges and considerations in implementing these therapies in clinical practice.
Takeaway
Incorporating recent advancements in noninvasive ventilation, high-flow nasal cannula therapy, and extracorporeal carbon dioxide removal can improve the management of acute respiratory failure. Healthcare providers should consider these evolving strategies to optimize patient care.
Respiratory muscle disorders
Respiratory muscle disorders
Disorders of the Respiratory Muscles
Franco Laghi et al., American Journal of Respiratory and Critical Care Medicine (2003)
What’s inside
This article provides a comprehensive overview of acute respiratory failure, detailing its pathophysiology, clinical manifestations, and management strategies. It emphasizes the importance of understanding the underlying mechanisms to effectively diagnose and treat this critical condition.
Why it’s relevant
Acute respiratory failure is a life-threatening condition that requires prompt recognition and intervention. A thorough understanding of its pathophysiology and clinical presentation is essential for healthcare professionals to provide optimal care.
Key focus
- Detailed exploration of the mechanisms leading to respiratory failure, including impairments in gas exchange and respiratory muscle function.
- Clinical features and diagnostic criteria essential for identifying respiratory failure in patients.
- Comprehensive overview of management strategies, encompassing both non-invasive and invasive interventions.
- Discussion on the role of mechanical ventilation and adjunctive therapies in the treatment of respiratory failure.
Takeaway
A deep understanding of the complex mechanisms and clinical aspects of respiratory failure is crucial for implementing effective management strategies, ultimately improving patient outcomes in critical care settings.