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Acute respiratory distress syndrome is characterized by the sudden onset of hypoxemia and bilateral pulmonary edema without cardiac failure. Sepsis is the most common cause of ARDS. The underlying mechanism and histologic correlate is diffuse alveolar damage (DAD). Diffuse alveolar damage involves damage to the endothelial and alveolar epithelial cells and is associated with inflammation and the development of hyaline membranes lining the inner alveolar walls. The reparative stage follows after weeks, with fibrosis possibly occurring later. Clinically, the following triad of findings favors a diagnosis of ARDS: acute or rapidly progressive dyspnea, hypoxic respiratory failure (partial pressure of O2/fraction of inspired O2 ratio < 300 mm Hg), and bilateral alveolar opacities on chest imaging. Management involves determination and treatment of the cause while providing adequate oxygen, reducing further lung damage, and avoiding fluid overload. Most patients require mechanical ventilation. Acute respiratory distress syndrome is associated with high mortality or long-term complications potentially developing even after treatment.

Respiratory Failure

Respiratory failure is a syndrome that develops when the respiratory system is unable to maintain oxygenation and/or ventilation. Respiratory failure may be acute or chronic and is classified as hypoxemic, hypercapnic, or a combination of the two. A number of etiologies exist, including diseases of the lungs, cardiovascular, and nervous system. Patients with respiratory failure may present with dyspnea, tachypnea, and altered mentation. The diagnosis is made with arterial blood gas and supplemented with laboratory and imaging studies to elicit an etiology. Management involves treating the underlying cause, supplemental oxygen administration, and mechanical ventilation for severe cases.

Asthma

Asthma is a chronic inflammatory respiratory condition characterized by bronchial hyperresponsiveness and airflow obstruction. The disease is believed to result from the complex interaction of host and environmental factors that increase disease predisposition, with inflammation causing symptoms and structural changes. Patients typically present with wheezing, cough, and dyspnea. Diagnosis is confirmed with a pulmonary function test showing a reversible obstructive pattern. Treatment, based on symptom severity, includes bronchodilators and inhaled corticosteroids for control of inflammation. Biologic agents targeting inflammatory mediators have been developed for severe persistent asthma.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a disorder characterized by recurrent obstruction of the upper airway during sleep, causing hypoxia and fragmented sleep. Obstructive sleep apnea is due to a partial or complete collapse of the upper airway and is associated with snoring, restlessness, sleep interruption, and daytime somnolence. The diagnosis relies on medical history, and polysomnography can confirm the diagnosis. Management includes lifestyle changes, methods of positive airway pressure, and surgical intervention.

COVID-19 (Coronavirus disease 2019)

COVID-19, also known as Coronavirus disease, is a respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2). Transmission mainly occurs via direct contact or aerosol droplets. The disease may present asymptomatically or with fever and dry cough.

Diseases of the Chest Wall and Respiratory Muscles Disorders — Diagnosis and Management

The alteration of the lung volume, in the form of reduction of total lung capacity (TLC), is regarded to restrictive lung diseases; as a rule the diseases of the chest wall and muscles, neuromuscular apparatus stipulate it; also, there are parenchymal ailments that may adjust the respiratory function of the lungs. The former ones lead to the decrease of TLC and refer to extrapulmonary diseases, and vice versa, the latter ones cause elevated TLC, like in COPD and asthma.

Obesity Hypoventilation Syndrome (Pickwickian Syndrome) — Definition and Pathophysiology

The problem of obesity has already affected almost all corners of the world, thus causing emergence of syndromes and symptoms in all known diseases creating new comorbidities as well as separate ailments. Therefore, innovations and alterations in medical management of various illnesses are required. In 2015, approximately 1 in 3 adults on the planet were predicted to suffer from excess body mass (BMI>25kg/m2) and 10% of the world population was diagnosed as having obesity (BMI>30kg/m2). One of the syndromes that come with being obese is obesity hypoventilation syndrome (OHS) stipulated by a quotidian alveolar hypoventilation (PCO2 >45mm Hg), while other conventional reasons for the condition are absent. OHS is the causative factor of intensive usage of hospital beds nowadays. In addition, it is a leading factor in the development of cardiorespiratory diseases.

Physiology of Acid-Base Balance

The pH of the blood is tightly regulated within the range 7.35–7.45 to ensure proper physiologic functions. Large amounts of acid are generated each day through normal processes (aerobic/anaerobic respiration and dietary intake), and these are efficiently managed and eliminated by buffers in the blood, the respiratory system, and the renal system. When these regulatory systems are disturbed, acid–base balance disorders occur, including respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.

Disorders of Respiratory Physiology 05:01 min

Disorders of Respiratory Physiology 3 quiz questions

Disorders of Respiratory Physiology 2 articles
Acute Respiratory Distress Syndrome 03:48 min

Acute Respiratory Distress Syndrome 3 quiz questions

Acute Respiratory Distress Syndrome 2 articles
Patterns of Acid-base Disorders 05:51 min

Patterns of Acid-base Disorders 4 quiz questions

Patterns of Acid-base Disorders 1 article
Treatment of Type 2 Respiratory Failure 03:35 min

Treatment of Type 2 Respiratory Failure 3 quiz questions

Treatment of Type 2 Respiratory Failure 1 article
Obstructive Sleep Apnea 07:24 min

Obstructive Sleep Apnea 8 quiz questions

Obstructive Sleep Apnea 1 article
Obesity Hypoventilation Syndrome 02:57 min

Obesity Hypoventilation Syndrome 1 quiz question

Obesity Hypoventilation Syndrome 1 article
Chest Wall and Muscle Disease 03:19 min

Chest Wall and Muscle Disease 2 quiz questions

Chest Wall and Muscle Disease 1 article

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Other Respiratory Disorders

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Your Educators of course Other Respiratory Disorders

Jeremy Brown, PhD

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