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Related Concept Videos

Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

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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.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
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Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

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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.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
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Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

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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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Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

575
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
575
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

163
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-IV01:23

Acute Respiratory Failure-IV

366
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 right ventricular dysfunction in severe COVID-19 pneumonia.

Yun-Long Li1, Jun-Bo Zheng1, Yu Jin2

  • 1Department of Intensive Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, P. R. China.

Reviews in Cardiovascular Medicine
|January 3, 2021
PubMed
Summary

Right heart function is impaired in critically-severe coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome (ARDS). Echocardiography revealed decreased tricuspid annular plane systolic excursion (TAPSE) and enlarged right heart chambers in severe cases.

Keywords:
Coronavirus disease 2019acute respiratory distress syndromeechocardiographyretrospective studyright ventricular function

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Area of Science:

  • Cardiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) can lead to acute respiratory distress syndrome (ARDS).
  • Right heart dysfunction is a potential complication in severe respiratory illnesses.
  • Understanding the impact of COVID-19 ARDS on right heart function is crucial for patient management.

Purpose of the Study:

  • To investigate right heart function in COVID-19 patients with ARDS.
  • To compare right heart parameters between different severity groups of COVID-19 ARDS.
  • To identify echocardiographic indicators of right heart impairment in COVID-19 ARDS.

Main Methods:

  • Retrospective analysis of 49 COVID-19 patients with ARDS.
  • Division of patients into severe and critically-severe groups based on illness severity.
  • Echocardiographic assessment of cardiac dimensions, tricuspid annular plane systolic excursion (TAPSE), inferior vena cava (IVC) parameters, and left ventricular ejection fraction (LVEF).
  • Comparison with age-matched healthy volunteers.

Main Results:

  • Tricuspid annular plane systolic excursion (TAPSE) was significantly decreased in COVID-19 ARDS patients compared to healthy controls, and further reduced in critically-severe cases.
  • Critically-severe patients exhibited increased maximum and minimum IVC diameters (IVCmax, IVCmin) and decreased IVC collapse index (ICV-CI).
  • COVID-19 ARDS patients showed enlarged right atrium and ventricle. Left ventricular ejection fraction (LVEF) was lower in critically-severe patients.

Conclusions:

  • Right ventricular function is impaired in critically-severe COVID-19 patients with ARDS.
  • Echocardiography reveals significant right heart abnormalities in these patients.
  • Assessment and protection of right heart function should be prioritized in managing COVID-19 ARDS.