The bankruptcy of the lungs and respiratory gas exchange in respiratory failure, as needed, can not perform even at rest. Although a further period of respiratory failure Respiratory bankruptcy clinical and pathophysiological concept is difficult to separate these two.
Clinically, respiratory failure, shortness of breath and difficulty breathing authenticating. Respiratory failure of the air entering and leaving the lungs of patients despite all the efforts were unsatisfactory, I can not do a better breathing or air hunger hears laments and closeness. Hypoxemia, respiratory failure, there is only the beginning. PA02 rest is less than 60mm Hg. PaC02 proceed out of the disease on the respiratory acidosis develops in the normal limit of 45 mm Hg. Respiratory failure may be acute or chronic.
Falls below 50 mm Hg in one patient, PA02 birdenibire PaC02 50mm Hg and acute respiratory failure that usually happens if the above. The main cause of respiratory failure in chronic obstructive pulmonary disease. Pathophysiologic abnormality leading to respiratory failure and ventilation abnormalities in these patients usually (alveolar hypoventilation), and ventilation / perfusion deterioration of the balance. Other causes of respiratory failure, restrictive lung disease, cardio-vascular diseases, neuromuscular diseases and respiratory depression.
Chronic obstructive pulmonary disease
Respiratory failure in a patient with chronic obstructive pulmonary disease, whether before explored. This history is important in the diagnosis of the disease. Frequent repetition of the upper respiratory tract infections is important for the diagnosis of chronic obstructive pulmonary disease. In these patients, either gradually or suddenly there is an increasing dyspnea. Exertion Dyspnea initially felt. Later, dyspnea occurs at rest.
On physical examination, additional bronchial tones (sibilan, ronflan Railer) heard in the airway obstruction is indicated. Railer how rough the bronchi of the obstruction, mucus secretion is so large and there are usually so. Can be heard at the end of a maximal expiratory bronchial obstruction under sibilan Railer is indicated, this Railer sometimes sounds better than at the level of the trachea. Of different character in different regions of the lungs of a non-homogeneous ventilation symptom of respiratory sounds heard, frequently observed in chronic obstructive pulmonary disease and a major cause of respiratory failure. The disease can be mild nature of the physical examination, normal findings. Chronic obstructive pulmonary disease and the degree of radiological examination in the diagnosis of the disease would not be very useful. However, radiological signs of emphysema in patients with two or three of the following written finding is important for diagnosis: (1) yassılaşması the diaphragm, (2) retrosternal air district to have a lot of third part, (3) have a lot of 90 degrees and the angle between the sternum and the diaphragm (4) more than presence of cool regions. Furthermore, lung vascular shadows periferies decreases, the heart appears small, the main pulmonary arteries are dilated. In cases of chronic bronchitis, chronic infection in the lungs than the change observed. Chest radiography is an important step in differential diagnosis. For example pnömokonyosis obstructive lung diseases may resemble the clinical symptoms and infections. Different nature, however, the radiographic manifestations.
Lung ventilation and perfusion scintigraphy can be applied in almost every patient without objection. Is an important problem in patients with chronic obstructive pulmonary ventilation and is a useful method for evaluation of abnormalities in perflizyon.
Chronic obstructive pulmonary disease and respiratory failure in lung function tests, especially the 1-day practical assessment seconds, forced vital capacity, diffusion capacity and arterial blood gases (pH, PA02 and PaC02) are evaluated. These patients often repeated blood count and electrocardiography.
Restrictive lung diseases
Lung parenkimasının common diseases and infections, pleural diseases and thoracic deformities, respiratory function, respiratory failure cause by making a restrictive effect.
The main complaints of shortness of breath, restrictive lung disease, as patients feel that closeness. Lungs of air could not say as much as necessary. Tachypnea, and are increasingly severe syanoz. Cough and phlegm is not as important as chronic obstructive pulmonary disease.
On physical examination, breath sounds are coarse or normal. Sometimes spontaneous breathing or coughing after only a thin crepitan Railer widely heard in the lungs.
Chest radiography is widespread infiltration. Restrictive lung diseases, however, the specific nature of change is not radiological. The patient's background, clinical findings and chest radiograph were examined, along with some laboratory tests would be more meaningful. Blood count, electrocardiography is useful in evaluating the prognosis of disease. Biopsy for definitive diagnosis is made if necessary.
Evaluation of lung function tests and degree of restrictive lung abnormality is very useful. This is a useful practical purpose, tests of lung volumes (especially the vital capacity), 1 Seconds, forced vital capacity, minute ventilation, diffusing capacity and arterial blood gases.
Cardiovascular diseases, Cardiovascular Disease
Both obstructive and restrictive lung disease progressively increasing hypoxemia, pulmonary hypertension and right heart hypertrophy causes. In the presence of respiratory failure and lung-heart disease worsens the prognosis further. Furthermore, chronic obstructive or restrictive lung disease with left ventricular failure can be found. a good history, careful clinical examination, chest radiography, ECG, lung function tests and arterial blood gases are useful in evaluating such a possibility. PC02 of arterial blood hypoxemia found an abnormal increase in heart failure in chronic obstructive pulmonary disease usually shows together.
Other factors such as neuromuscular diseases other than lung and heart-vascular abnormalities, respiratory depression, acute anemia, suffocation, burning, oxygen toxicity, myxedema, metabolic abnormalities may lead to respiratory failure.
Treatment
The earlier the treatment of respiratory failure than success would be so. Better yet respiratory failure patients should be treated for the disease before entering the necessary measures should be taken to proceed. Respiratory failure is the leading cause of chronic obstructive pulmonary disease, restrictive lung disease and other diseases and complications of complying with the characteristics of the disease is treated.
Respiratory failure is the success of hospital treatment provided in a specific intensive respiratory care units-mamışsa patient transported.
Chronic lung disease usually caused by hypoxemia alve-dying hypoventilation and ventilation / perfusion imbalance associated with. Usually depends on the alveolar hipoventilasyona hypercarbia. C02 gas is 20 times more oxygen diffusion to the quality of leads to the development of hypoxemia before hypercarbic. A period of severe chronic obstructive pulmonary disease and respiratory failure developed in all patients with respiratory functions and particularly the increased blood gases should be examined frequently. Intermittent positive pressure breathing (İPBS) is a type of artificial ventilation in intensive care underwent a major. Patient and disease characteristics of cases of respiratory failure indication İPBS depends. İPBS'in main indications in adults:
1. Per minute, respiratory rate of more than 35.
2. Vital capacity 10-15 ml / kg is less.
3. PA02 of breathing pure oxygen nasal catheter is less than 70 mm Hg.
4. Of more than 60mm of Hg PaC02.
5. Clinical symptoms, such as increasing dyspnea and chest X-ray lesions.
6. Despite the decrease of PA02 and PaC02 increase of the required treatment.
The main reason for respiratory failure should be kept in the forefront of treatment of the disease. For example, in the case of status asthmaticus bronchodilator in the treatment of choice, and if necessary, tracheo-bronchial aspirasyondur steroid treatment. Respiratory failure due to left heart failure, pulmonary edema is a result of diuretic treatment of choice here, digital, salt-free regime, and oxygen therapy;
Nutrition in patients with respiratory failure
Of serious digestive disorders is common in patients with chronic obstructive lung and respiratory failure. To do daily activities, especially for chronic obstructive pulmonary ill shall make more calories than normal persons. Disease and increase of calories will vary according to the person özellekliklerine. Body weight is more than can cause lung and heart work harder. The weakening of the patients fat, normal weight, dizziness, an important treatment.
Respiratory failure patients nearly twice as many times the basal metabolic requirements (eg 3000/kalori/gün) should. Indicates that respiratory failure is less than 1200 m3 of total lymphocytes. In these patients, daily protein 0.75-1 gm / kg, dir. And carbohydrate / fat ratio should be 50/50 so many times. Digestive difficulties with less food should be preferred. Food may increase respiratory problems. To prevent this, the need to eat 4-6 meals per day must meet.
Showing posts with label Respiratory Failure. Show all posts
Showing posts with label Respiratory Failure. Show all posts
Pulmonary Edema, Acute Lung Edema Treatment
Pulmonary capillary pressure increases or decreases of plasma osmotic pressure polmoner edema occurs. The main factor in the occurrence of pulmonary edema, capillary pressure is elevated. Capillary pressure is the major factor in increasing the pressure will increase venalarda. The main factors that increase venous pressure in the left heart disease.
Heart disease, lung edema
Left heart disease the leading cause of lung edema. It follows other heart diseases. Pulmonary edema before the air spaces (alveoli and bronchi) interstisiyumda occurs in the vicinity. Pulmonary edema at the beginning of dyspnea, orthopnea and dry cough, although complaining of a symptom can not be heard oksültasyonunda lungs.
Pulmonary edema in cases of heart is usually enlarged.
The classic symptoms of pulmonary edema, severe dyspnea, orthopnea and dry cough. Frothy sputum, and a dry cough along with plenty of character or will. In some cases of mitral stenosis as well as pink sputum or blood is türkür-Mesi. On physical examination, tachypnea, syanoz, Auscultation of lung bases crepitan Railer monitored. Railer in such fields as the disease progresses, the upper lung sounds. As symptoms of congestive failure is increased systemic venous pressure, hepatic and peripheral edema tosplenomegali occurs.
Pulmonary interstitial and alveolar edema often seen with radiography. Hilar vascular shadows, borders and belirsizleşir, thickened interlobular septa (Kerley B lines).
Pulmonary edema pulmonary functions
Pulmonary edema in respiratory functions consist of restrictive nature. Vital capacity, reduced compliance, vascular resistance increases. If a more serious nature edema residual volume, airway resistance increases air flow is reduced and the respiratory tract. Positive-pressure breathing increases compliance, but not a change in pulmonary resistance. intravenous aminophylline and bronchial vascular resistance and compliance as well as fixes.
Patients often have hypoxemia. Interstitial edema, hypoxemia is more serious cases. However, normal or decreased arterial pC02 kanırda. Too serious a significant edema formation of oedemas alveoli filled pC02 increases as a result of alveolar hypoventilation, a respiratory acidosis develops. The main cause of hypoxemia in lung edema due to edema interstisiyumdaki prolongation of the road for gas diffusion and ventilation / perfusion balance relates bozulmasiyle.
Kidney disease can develop pulmonary edema. This is mainly because of pulmonary edema is left heart yetersiliğidir diseases. Intravenous fluid given to the elderly, especially in the postoperative period and pulmonary edema may husule. Facilitates reduction of blood proteins in lung edema.
Some of the people living at sea level in a short period of time (eg 1-2 days) 3000 meters or more above pulmonary edema can occur when they came out. Or living in the heights when they return to the old place a few weeks after sitting down climates may develop pulmonary edema. This has the effect of cold air and exercise in the occurrence of edema. Pulmonary veins constriction, hypoxia, alkalosis, the lungs and pulmonary hypertension altitude edema are the major causes more fluid to pass. Oxygen breathing or the patient's immediate recovery götürülmesiyle sea level, is provided.
The primary treatment of lung edema and edema to facilitate the treatment of heart diseases or other factors, to correct the system.
Heart disease, lung edema
Left heart disease the leading cause of lung edema. It follows other heart diseases. Pulmonary edema before the air spaces (alveoli and bronchi) interstisiyumda occurs in the vicinity. Pulmonary edema at the beginning of dyspnea, orthopnea and dry cough, although complaining of a symptom can not be heard oksültasyonunda lungs.
Pulmonary edema in cases of heart is usually enlarged.
The classic symptoms of pulmonary edema, severe dyspnea, orthopnea and dry cough. Frothy sputum, and a dry cough along with plenty of character or will. In some cases of mitral stenosis as well as pink sputum or blood is türkür-Mesi. On physical examination, tachypnea, syanoz, Auscultation of lung bases crepitan Railer monitored. Railer in such fields as the disease progresses, the upper lung sounds. As symptoms of congestive failure is increased systemic venous pressure, hepatic and peripheral edema tosplenomegali occurs.
Pulmonary interstitial and alveolar edema often seen with radiography. Hilar vascular shadows, borders and belirsizleşir, thickened interlobular septa (Kerley B lines).
Pulmonary edema pulmonary functions
Pulmonary edema in respiratory functions consist of restrictive nature. Vital capacity, reduced compliance, vascular resistance increases. If a more serious nature edema residual volume, airway resistance increases air flow is reduced and the respiratory tract. Positive-pressure breathing increases compliance, but not a change in pulmonary resistance. intravenous aminophylline and bronchial vascular resistance and compliance as well as fixes.
Patients often have hypoxemia. Interstitial edema, hypoxemia is more serious cases. However, normal or decreased arterial pC02 kanırda. Too serious a significant edema formation of oedemas alveoli filled pC02 increases as a result of alveolar hypoventilation, a respiratory acidosis develops. The main cause of hypoxemia in lung edema due to edema interstisiyumdaki prolongation of the road for gas diffusion and ventilation / perfusion balance relates bozulmasiyle.
Kidney disease can develop pulmonary edema. This is mainly because of pulmonary edema is left heart yetersiliğidir diseases. Intravenous fluid given to the elderly, especially in the postoperative period and pulmonary edema may husule. Facilitates reduction of blood proteins in lung edema.
Some of the people living at sea level in a short period of time (eg 1-2 days) 3000 meters or more above pulmonary edema can occur when they came out. Or living in the heights when they return to the old place a few weeks after sitting down climates may develop pulmonary edema. This has the effect of cold air and exercise in the occurrence of edema. Pulmonary veins constriction, hypoxia, alkalosis, the lungs and pulmonary hypertension altitude edema are the major causes more fluid to pass. Oxygen breathing or the patient's immediate recovery götürülmesiyle sea level, is provided.
The primary treatment of lung edema and edema to facilitate the treatment of heart diseases or other factors, to correct the system.
Respiratory insufficiency
Respiratory Failure Disease
As a result of abnormalities in lung structure or function, right ventricular hypertrophy or dilatation is called cor pulmonale. Left heart disease and congenital heart diseases such as heart and lung abnormalities that develop core pulmonale'de. However, these abnormalities are related to complications of heart disease.
Etiology
The main cause of Cor pulmonale in chronic obstructive pulmonary diseases (chronic bronchitis and emphysema), dir. 20% of all heart diseases, cor pulmonale.
Such as chronic bronchitis and emphysema often found together in some cases are associated with asthma. Chronic obstructive pulmonary disease progresses, and some of the facilitating factors, for example, pneumonia is a lung disease such as cor pulmonale turns.
Pulmonary hypertension is the major factor in the occurrence of cor pulmonale and right heart failure. There is an important contribution to the development of pulmonary hypertension and hypoxia. Hypoxemia with chronic obstructive pulmonary disease develops before the exertion. Later, the rest is hypoxemia. Hypercarbia during more advanced disease (increase of C02 in the blood) develops. Hypoxemia, such as increased pulmonary vascular resistance caused by the increase C02'nin vasokonstriksiyon by facilitating the effect of an increase in pulmonary hepertansiyonun more help.
Clinical symptoms
Chronic obstructive pulmonary disease (COPD) patients in cor pulmonale caused by smoking more often içenlerdir years. Cor pulmonale for many years before there are dyspnea and cough. Progress or an infection such as pneumonia, lung function komplikasyonuyla KOAH'mn more disturbed than cor pulmonale and right heart failure and then converted.
On physical examination, dyspnea, syanoz, tachypnea, wheezing and a respiratory (wheezing) are available. Syanoz, cor pulmonale is a common finding. Especially in the cases of bronchiectasis and chronic bronchitis are the fingers, clubbing-encounter. Advanced, patients with respiratory acidosis, decreased consciousness, coma, drowsiness, and may. As observed in the liver in patients with diminished tremor (asterixis), a common finding. Dizorientasyon, headache, speech disorder, small pupil, fast-sıçrayıcı pulse, warm and moist hand and papillary edema, respiratory acidosis other related symptoms.
Heart failure occurred and jugular venous pressure (venous pressure increase) occurs. Respiratory muscles, respiratory support and help, such as the sternocleidomastoid skalenus çabalarıyle dyspnea becomes more specific. Puckered lips of the patient breathes to prevent collapse of the bronchi. Increased thoracic anterior-posterior diameter. Intercostal spaces and ribs enlarged severe respiratory movements decreased. Palpation the left sternal border, right ventricular push monitored. Much air is filled with percussion and diaphragmatic movements in a specific reduction in lung hipersonorite determined. Cor pulmonale in emphysema patients developing liver is pushed down. Hepatemegali karıştırmamalıdır with this. Auscultation hafiflediği breath sounds, prolonged expiratory inspiration and expiration sibilan, ronflan Railer heard.
P2 is exacerbated. Range is increased because of emphysema and pulmonary heart toraks'arasındaki with hardly hear heart sounds. The patient is fixed firm dinlenince voices sounded more certain. In some cases, transient arrhythmias heard.
There is edema of the legs in cases of right heart failure, ECG findings of right ventricular hypertrophy seen.
Radiological findings
Heart is usually enlarged. However, this expansion is not always apparent. Anterior-posterior diameter of the lateral radiograph of the heart can be seen growing. Suspicious cases, the patient's current movie film taken in a comparative old flimleriyle or after treatment. If there is a difference cardiomegaly finalized. Emphysema-than-air appearance of lungs in cases of cor pulmonale (hyperinflation) and are sometimes monitored fibrosis. Itilme diaphragm down, and kubbeleşme flattening occurs.
Lung function tests Lung Function Test
Lung function tests, the cause of cor pulmonale with COPD or other lung disease is a nature and degree of functional impairment would be enlightening. The disease progresses, forced vital capacity, 1 second percentage (ZVK1), diffusing capacity (DA), and arterial blood oxygen tension (PA02) is reduced. A more serious situation occurs when the arterial blood PaC02 increased by respiratory acidosis. Lung function tests and arterial blood gas, especially in the course of the disease and evaluate the success of treatment is very useful.
Laboratory examination
Is most often seen in cases of polycythemia and cor pulmonale. If you have an intercurrent infection increases white blood cell.
ECG Findings: 2 / 3 cases of cor pulmonale have ECG findings of right ventricular hypertrophy. Some of the ECG is normal in cases of cor pulmonale.
Other lung diseases, cor pulmonale
Advanced stages of chronic diseases of the thorax and lung parenkimasının pulmole husule bring core. Widespread fibrosis, scleroderma, pneumococcal-yozlar, diffuse bilateral tuberculosis, cancer metastasis, widespread, kolagen diseases, and lung parenkimasının sarkoidosis other hastalıklarıda cause cor pulmonale. The remaining lung after pneumonectomy and lobectomy emphysema, chronic bronchitis may be caused as a progressive disease develops core pulmonale'ye. Pleural diseases, severe kyphoscoliosis, Pickwick syndrome, neuropathy, myopathies, and vascular diseases of the lung, cor pulmonale may occur, especially thrombo-embolism.
Treatment of Cor pulmonale
If you have the right heart hypertrophy and heart failure, which causes lung disease treatment is applied with. Lack of ventilation for the treatment of infection, bronkospasm, hypoxia should be under control, as well as diuretics and cardiac decompensation should be treated digitalis'le.
Most patients with chronic bronchitis and emphysema, smoking drink. Non-bronchial secretion and increases the resistance of the respiratory tract. Smoking slows down the course and complications of the disease is left is reduced. Purulent sputum, listening to localized or generalized years, dry Railer, leukocytosis, and chest radiography, lung infection in areas of concentration will be indicated. Sputum culture and antibiotic sensitivity of bacteria (antibiotic) to be examined is treated with antibiotics. Bronchodilator drugs better ventilation will help reduce bronkospasmı. Concentration of 25-35% oxygen inhalation for the treatment of hypoxemia than once is enough.
Digital and diuretic drugs in the treatment of right heart failure is an important place. Salt-free diet should be applied.
Hypoxemia and respiratory acidosis uncontrolled patients are treated in intensive care units.
Lung transplantation
In some patients, despite the treatment advances and life-threatening right heart failure. In these patients, lung transplant to save his life and prolong life. Cases of bilateral lung transplantation or heart or lung transplantation than are ünlateral
Prognosis
Cor pulmonale, right heart failure and the development of poor-prognosis leştirir. For example, the mortality rate within 4 years, 50% of cases of cor pulmonale, right heart failure, although it is 75% of cases is growing. The important thing is to take measures to delay or prevent right heart failure. Once it starts, right-heart failure than the others, followed by shorter periods of time. Oxygen therapy in hypoxemic patients with pulmonary hypertension will decrease. Therefore, ambulatory oxygen therapy is needed portable gadgets. Decrease of right heart failure in patients with this treatment is applied to obtain a better prognosis.
As a result of abnormalities in lung structure or function, right ventricular hypertrophy or dilatation is called cor pulmonale. Left heart disease and congenital heart diseases such as heart and lung abnormalities that develop core pulmonale'de. However, these abnormalities are related to complications of heart disease.
Etiology
The main cause of Cor pulmonale in chronic obstructive pulmonary diseases (chronic bronchitis and emphysema), dir. 20% of all heart diseases, cor pulmonale.
Such as chronic bronchitis and emphysema often found together in some cases are associated with asthma. Chronic obstructive pulmonary disease progresses, and some of the facilitating factors, for example, pneumonia is a lung disease such as cor pulmonale turns.
Pulmonary hypertension is the major factor in the occurrence of cor pulmonale and right heart failure. There is an important contribution to the development of pulmonary hypertension and hypoxia. Hypoxemia with chronic obstructive pulmonary disease develops before the exertion. Later, the rest is hypoxemia. Hypercarbia during more advanced disease (increase of C02 in the blood) develops. Hypoxemia, such as increased pulmonary vascular resistance caused by the increase C02'nin vasokonstriksiyon by facilitating the effect of an increase in pulmonary hepertansiyonun more help.
Clinical symptoms
Chronic obstructive pulmonary disease (COPD) patients in cor pulmonale caused by smoking more often içenlerdir years. Cor pulmonale for many years before there are dyspnea and cough. Progress or an infection such as pneumonia, lung function komplikasyonuyla KOAH'mn more disturbed than cor pulmonale and right heart failure and then converted.
On physical examination, dyspnea, syanoz, tachypnea, wheezing and a respiratory (wheezing) are available. Syanoz, cor pulmonale is a common finding. Especially in the cases of bronchiectasis and chronic bronchitis are the fingers, clubbing-encounter. Advanced, patients with respiratory acidosis, decreased consciousness, coma, drowsiness, and may. As observed in the liver in patients with diminished tremor (asterixis), a common finding. Dizorientasyon, headache, speech disorder, small pupil, fast-sıçrayıcı pulse, warm and moist hand and papillary edema, respiratory acidosis other related symptoms.
Heart failure occurred and jugular venous pressure (venous pressure increase) occurs. Respiratory muscles, respiratory support and help, such as the sternocleidomastoid skalenus çabalarıyle dyspnea becomes more specific. Puckered lips of the patient breathes to prevent collapse of the bronchi. Increased thoracic anterior-posterior diameter. Intercostal spaces and ribs enlarged severe respiratory movements decreased. Palpation the left sternal border, right ventricular push monitored. Much air is filled with percussion and diaphragmatic movements in a specific reduction in lung hipersonorite determined. Cor pulmonale in emphysema patients developing liver is pushed down. Hepatemegali karıştırmamalıdır with this. Auscultation hafiflediği breath sounds, prolonged expiratory inspiration and expiration sibilan, ronflan Railer heard.
P2 is exacerbated. Range is increased because of emphysema and pulmonary heart toraks'arasındaki with hardly hear heart sounds. The patient is fixed firm dinlenince voices sounded more certain. In some cases, transient arrhythmias heard.
There is edema of the legs in cases of right heart failure, ECG findings of right ventricular hypertrophy seen.
Radiological findings
Heart is usually enlarged. However, this expansion is not always apparent. Anterior-posterior diameter of the lateral radiograph of the heart can be seen growing. Suspicious cases, the patient's current movie film taken in a comparative old flimleriyle or after treatment. If there is a difference cardiomegaly finalized. Emphysema-than-air appearance of lungs in cases of cor pulmonale (hyperinflation) and are sometimes monitored fibrosis. Itilme diaphragm down, and kubbeleşme flattening occurs.
Lung function tests Lung Function Test
Lung function tests, the cause of cor pulmonale with COPD or other lung disease is a nature and degree of functional impairment would be enlightening. The disease progresses, forced vital capacity, 1 second percentage (ZVK1), diffusing capacity (DA), and arterial blood oxygen tension (PA02) is reduced. A more serious situation occurs when the arterial blood PaC02 increased by respiratory acidosis. Lung function tests and arterial blood gas, especially in the course of the disease and evaluate the success of treatment is very useful.
Laboratory examination
Is most often seen in cases of polycythemia and cor pulmonale. If you have an intercurrent infection increases white blood cell.
ECG Findings: 2 / 3 cases of cor pulmonale have ECG findings of right ventricular hypertrophy. Some of the ECG is normal in cases of cor pulmonale.
Other lung diseases, cor pulmonale
Advanced stages of chronic diseases of the thorax and lung parenkimasının pulmole husule bring core. Widespread fibrosis, scleroderma, pneumococcal-yozlar, diffuse bilateral tuberculosis, cancer metastasis, widespread, kolagen diseases, and lung parenkimasının sarkoidosis other hastalıklarıda cause cor pulmonale. The remaining lung after pneumonectomy and lobectomy emphysema, chronic bronchitis may be caused as a progressive disease develops core pulmonale'ye. Pleural diseases, severe kyphoscoliosis, Pickwick syndrome, neuropathy, myopathies, and vascular diseases of the lung, cor pulmonale may occur, especially thrombo-embolism.
Treatment of Cor pulmonale
If you have the right heart hypertrophy and heart failure, which causes lung disease treatment is applied with. Lack of ventilation for the treatment of infection, bronkospasm, hypoxia should be under control, as well as diuretics and cardiac decompensation should be treated digitalis'le.
Most patients with chronic bronchitis and emphysema, smoking drink. Non-bronchial secretion and increases the resistance of the respiratory tract. Smoking slows down the course and complications of the disease is left is reduced. Purulent sputum, listening to localized or generalized years, dry Railer, leukocytosis, and chest radiography, lung infection in areas of concentration will be indicated. Sputum culture and antibiotic sensitivity of bacteria (antibiotic) to be examined is treated with antibiotics. Bronchodilator drugs better ventilation will help reduce bronkospasmı. Concentration of 25-35% oxygen inhalation for the treatment of hypoxemia than once is enough.
Digital and diuretic drugs in the treatment of right heart failure is an important place. Salt-free diet should be applied.
Hypoxemia and respiratory acidosis uncontrolled patients are treated in intensive care units.
Lung transplantation
In some patients, despite the treatment advances and life-threatening right heart failure. In these patients, lung transplant to save his life and prolong life. Cases of bilateral lung transplantation or heart or lung transplantation than are ünlateral
Prognosis
Cor pulmonale, right heart failure and the development of poor-prognosis leştirir. For example, the mortality rate within 4 years, 50% of cases of cor pulmonale, right heart failure, although it is 75% of cases is growing. The important thing is to take measures to delay or prevent right heart failure. Once it starts, right-heart failure than the others, followed by shorter periods of time. Oxygen therapy in hypoxemic patients with pulmonary hypertension will decrease. Therefore, ambulatory oxygen therapy is needed portable gadgets. Decrease of right heart failure in patients with this treatment is applied to obtain a better prognosis.
Subscribe to:
Posts (Atom)