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Assessing and monitoring blood gas levels is the most accurate means to identify a state of respiratory compromise in patients. ABG testing does however require an arterial blood sample, which is more invasive and uncomfortable for patients than a pulse oximetry reading that uses a reading based on light and color.
NPPE develops as a result of significant negative pressure generated in the chest cavity by inspiration against an upper airway obstruction. These negative pressures in the chest lead to increase venous supply to the right side of the heart while simultaneously creating more resistance for the left side of the heart to supply blood to the rest of the body (). [4]
Typically, infections cause 75% or more of the exacerbations; bacteria can roughly be found in 25% of cases, viruses in another 25%, and both viruses and bacteria in another 25%. Airway inflammation is increased during the exacerbation resulting in increased hyperinflation, reduced expiratory air flow and decreased gas exchange. [1] [2]
This leads to impaired gas exchange, most often leading to shortness of breath which can progress to hypoxemia and respiratory failure. Pulmonary edema has multiple causes and is traditionally classified as cardiogenic (caused by the heart) or noncardiogenic (all other types not caused by the heart).
Because gas exchange is impaired, signs of low blood oxygen saturation, such as low concentrations of oxygen in arterial blood gas and cyanosis (bluish color of the skin and mucous membranes) are commonly associated. [6] Dyspnea (painful breathing or difficulty breathing) is commonly seen, [6] and tolerance for exercise may be lowered. [7]
Respiratory failure results from inadequate gas exchange by the respiratory system, meaning that the arterial oxygen, carbon dioxide, or both cannot be kept at normal levels. A drop in the oxygen carried in the blood is known as hypoxemia ; a rise in arterial carbon dioxide levels is called hypercapnia .
Abnormal pulmonary function test results, with evidence of restriction and impaired gas exchange. Some of these features are due to chronic hypoxemia (oxygen deficiency in the blood), and are not specific for IPF, they can occur in other pulmonary disorders. IPF should be considered in all patients with unexplained chronic exertional dyspnea ...
Depending on the type and amount of irritant gas inhaled, victims can experience symptoms ranging from minor respiratory discomfort to acute airway and lung injury and even death. A common response cascade to a variety of irritant gases includes inflammation , edema and epithelial sloughing , which if left untreated can result in scar formation ...