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Related Concept Videos

Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

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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...
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Acute Respiratory Failure-II01:21

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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.
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Acute Respiratory Failure-V01:29

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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.
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Acute Respiratory Failure-III01:30

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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...
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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Updated: Nov 28, 2025

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
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Right ventricular dysfunction in critically ill COVID-19 ARDS.

Caroline Bleakley1, Suveer Singh2, Benjamin Garfield2

  • 1Department of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK; Department of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK.

International Journal of Cardiology
|November 26, 2020
PubMed
Summary
This summary is machine-generated.

Critically ill COVID-19 patients often have right ventricular (RV) impairment, particularly radial dysfunction. Echocardiography reveals specific RV phenotypes in severe COVID-19 acute respiratory distress syndrome (ARDS).

Keywords:
Acute respiratory distress syndromeCOVID-19Critical careEchocardiographyRight ventricle

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Pulmonology

Background:

  • Right ventricular (RV) impairment is common in critically ill patients but not well-characterized in COVID-19 acute respiratory distress syndrome (ARDS).
  • Echocardiography is crucial for assessing cardiac function, especially in severe respiratory failure.

Purpose of the Study:

  • To define the echocardiographic phenotype of RV impairment in COVID-19 ARDS.
  • To identify clinical, ventilatory, and laboratory associations of RV dysfunction in this cohort.

Main Methods:

  • Transthoracic echocardiography (TTE) was used to assess RV function in 90 critically ill COVID-19 patients.
  • Measures included RV fractional area change (FAC), RV velocity time integral (VTI), tricuspid annular plane systolic excursion (TAPSE), RVS', and RV free wall strain (FWS).
  • Associations with clinical, ventilatory, and laboratory data were analyzed using multivariate regression.

Main Results:

  • A high proportion of patients showed RV dysfunction by RV FAC (72.0%) and RV VTI (86.4%).
  • Longitudinal measures like TAPSE (23.8%) and RVS' (11.9%) identified less RV dysfunction.
  • RV FAC correlated with NTpro-BNP and pulmonary vascular resistance (PVR); RV-PA coupling was associated with PVR, RV dimensions, P/F ratio, PEEP, and ALT.

Conclusions:

  • Severe COVID-19 ARDS is linked to a distinct RV phenotype of radial impairment with preserved longitudinal function.
  • Relying solely on long-axis echocardiographic parameters may misinterpret RV health in these patients.
  • RV-PA coupling offers valuable insights beyond standard RV performance measures in COVID-19 ARDS.