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Related Concept Videos

Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Physiological Control of Respiration01:23

Physiological Control of Respiration

Introduction
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...

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Related Experiment Video

Updated: May 9, 2026

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
07:16

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient

Published on: November 30, 2022

Management of refractory hypoxemia in ARDS.

R M Kacmarek1, J Villar

  • 1Department of Respiratory Care, Massachusetts General Hospital, Boston, MA, USA - rkacmarek@partners.org.

Minerva Anestesiologica
|July 17, 2013
PubMed
Summary

Refractory hypoxemia in ARDS patients can be managed with lung recruitment, prone positioning, and vasodilators. High-frequency oscillation is not recommended for treating persistent hypoxemia.

Area of Science:

  • Critical Care Medicine
  • Pulmonary Medicine
  • Respiratory Physiology

Background:

  • Severe hypoxemia is characteristic of Acute Respiratory Distress Syndrome (ARDS).
  • Refractory hypoxemia, while rare, presents a significant management challenge even with lung protective ventilation and PEEP.
  • Persistent hypoxemia can lead to increased mortality in ARDS patients.

Purpose of the Study:

  • To outline a management strategy for refractory hypoxemia in ARDS patients.
  • To evaluate the efficacy of various interventions for unresolved hypoxemia.
  • To provide evidence-based recommendations for clinical practice.

Main Methods:

  • Review of current literature and clinical guidelines for ARDS management.
  • Analysis of treatment approaches including lung recruitment maneuvers, decremental PEEP trials, and prone positioning.

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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Related Experiment Videos

Last Updated: May 9, 2026

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
07:16

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient

Published on: November 30, 2022

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

  • Evaluation of adjunctive therapies like aerosolized pulmonary vasodilators and extracorporeal membrane oxygenation (ECMO).
  • Assessment of high-frequency oscillation (HFO) in refractory hypoxemia.

    • Main Results:

    • Lung recruitment maneuvers and decremental PEEP trials are recommended first-line treatments.
    • Prone positioning should be attempted if initial maneuvers fail to resolve hypoxemia.
    • Aerosolized pulmonary vasodilators can serve as a temporizing measure during ECMO transition.
    • Evidence does not support the use of HFO for refractory hypoxemia.

    Conclusions:

    • A stepwise approach involving lung recruitment, PEEP trials, and prone positioning is effective for refractory hypoxemia.
    • Vasoactive medications and ECMO are crucial for severe, unresolved cases.
    • High-frequency oscillation should be avoided in the management of refractory hypoxemia in ARDS.