Pulmonary Alterations

Pulmonary Alterations

1. PaCO2 concentrations

   • Hypoventilation
     • Hypercapnia (paCO2 >45)
       • Resp. acidosis
   • Hyperventilation
     • Hypocapnia (PaCO2 <35)
       • Resp. alkalosis

2. PaO2 concentrations

   • Hypoxemia
     • Hypoxia
   • Hyperoxemia

3. Chest Wall and Pleura Disorders

   • Chest wall restrictions
     • Kyphosis
     • Flail chest
   • Pleural wall abnorms
     • Hemo/pneumothorax (blood/air in pleural space)
       • Primary/spontaneuos
       • Secondary/traumatic
     • Pleural effusion (fluid in pleural space)
       • Transudative (watery)
       • Exudative (WBCs/plasma)
       • Empyema (pus)

4. Pulm Vascular Disease

   • Pulm. Embolism (high V/Q)
     • Resp. compromise
     • Hemodynamic compromise
   • Pulm. HTN
     • Primary idiopathic
     • Secondary/chronic alveolar hypoxia
   • Cor Pulmonale

5. Obstructive Disorders

   • COPD
     • Emphysema
     • Chronic bronchitis (low V/Q)
   • Asthma (low V/Q)
     • Atopic/allergic
     • Non-atopic

6. Pulm Edema

   • Cardiogenic
     • Increased hydrostatic pressure
       • L-sided heart failure
     • Decreased oncotic pressure
       • Hypoalbumenia
       • Nephrotic syndrome or liver disease
   • Noncardiogenic
     • Increased capillary permeability

7. ARDS (v. low V/Q/shunt)

   • MODS

8. Restrictive Disorders

   • Aspiration
   • Bronchiolitis
   • Fibrosis
     • viral
   • Atelectasis (v. low V/Q/shunt)
     • Compression
     • Absorption/Resorption
     • Surfactant Impairment
     • Contraction

9. Infections

   • URI
     • Cold
     • Sinus inf.
     • Pharyngitis
       • Strep pyrogenes
         • Rheumatic heart disease
     • Influenza
   • Lower resp.
     • Pneumonia (v. low V/Q/shunt)
     • TB