Acute Respiratory Failure For family, friends and caregivers of a patient with acute respiratory failure in the Medical Surgical Intensive Care Unit (MSICU) This brochure will give you more information about: The causes and symptoms of acute respiratory failure How acute respiratory failure is treated in the MSICU What you can do to help Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca 2017 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Author: Ingrid Daley, Dr. John Granton and Elke Ruthig Created: 06/2017 Form: D-8706
What is acute respiratory failure? Acute respiratory failure happens when not enough oxygen passes from the lungs into the blood. It can also happen if the lungs are not properly removing carbon dioxide gas from the blood. Both of these problems can happen at the same time. Acute respiratory failure can happen to anyone. Acute respiratory failure can lead to decreased consciousness (staying awake), changes in blood pressure and heart rate, changes in the chemicals in the blood, shock, damage to other organs in the body or death. What are the signs and symptoms? Shortness of breath or trouble breathing Fast breathing rate Low oxygen levels in the blood High carbon dioxide levels in the blood High heart rate Low or high blood pressure Bluish lips, bluish skin or both Decreased level of consciousness, such as drowsiness or a coma 2
What can cause acute respiratory failure? Acute respiratory failure may be caused by many things such as: Too much fluid in the lungs called pulmonary edema Blocked airway Decreased level of consciousness from a head injury, sedatives, drugs, alcohol etc. Acute Respiratory Distress Syndrome (ARDS) Weak breathing muscles or a neurological condition that causes weakness Pneumonia or a lung infection Bleeding in the chest Rejection of a lung transplant Lung conditions such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis or cancer Heart failure Stroke Obesity How is acute respiratory failure treated in the MSICU? Before treatment begins, several tests will be done. These tests may include: Blood tests Chest x-ray, CT scan, MRI or all of these An echocardiogram to check the heart A bronchoscopy (a procedure that lets a doctor look inside a lung with a camera) Cultures of secretions to look for infection (pneumonia) 3
Some medications that may be used to treat acute respiratory failure are: Corticosteroids to reduce swelling in the lungs Nitric-oxide to help with moving oxygen into the lungs Antibiotics Sedatives and pain medication that will help keep your loved one comfortable or make being on a breathing machine (ventilator) easier Paralytics to prevent the muscles from moving. They may be used to help the breathing machine work better and help reduce injury from the breathing machine Blood pressure medication Other treatments that may also be used to help during acute respiratory failure are: Fluid restriction or removing fluid from the body using medications or dialysis Mechanical ventilation (breathing machine) Extracorporeal Life Support (ECLS) a heart lung machine. An ECLS machine takes over the function of the lungs or heart until they can recover Chest tubes Laying a patient on their stomach to help improve oxygen levels Physiotherapy 4
What can I do to help? Substitute Decision Maker It is important for one family member to act on behalf of their loved one as a Substitute Decision Maker (SDM). An SDM is usually the most immediate next of kin, unless the patient chooses someone else. As a SDM, you are responsible for giving accurate and honest information about your loved one to the health care team. You also: Partner with the health care team to make sure you understand what is happening with your loved one Work together with the team to decide about the care and treatment of your loved one The SDM should try, as much as possible, to help the health care team make decisions based on what the patient would have made if they were able to talk. Please look for the brochure Substitute Decision Makers and Naming an Attorney for Personal Care in the MSICU waiting room. Please look for the brochure Substitute Decision Makers and Naming an Attorney for Personal Care in the MSICU waiting room. Comfort and support Although sometimes patients in the MSICU are taking sedating medication, they do still need emotional support from their friends or families. Talk to them like you would at home. Bring toiletries, familiar pictures, books and comforting items from home. Visiting hours Visiting hours are from 9:00 am to 11:00 pm every day, but we have a flexible visiting policy. Please talk to your nurse. Make sure only 2 people visiting your loved one at a time. Please try to keep your visits short and remember to let other family members in to visit. Try to limit the number of visitors until your loved one is in stable condition. 5
Hand washing You can help the health care team, your loved one and yourself by washing your hands well and often during your visits to MSICU. Please follow all isolation instructions or talk to your nurse if you are not sure what to do when visiting an isolation room. Who can I talk to if I have questions? Do not be afraid to ask questions, or ask any member of the healthcare team to repeat or say information in a different way. You can talk with any of the medical staff caring for your loved one about any concerns you may have. More information about acute respiratory failure Medline Plus National Institutes of Health National Heart, Lung and Blood Institute My questions 6