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PATHOPHYSIOLOGY

Definition

ARF is a common life threatening process with myriad causes. It is characterized by failure of oxygenation, or
ventilation, or both.

Schematic Diagram

Predisposing
Age- 82 years old
COPD Precipitating
COPD

Allergens enter the upper respiratory tract

Stimulation and activation of B Lymphocytes

B Lymphocytes produces Immunoglobulin E(IgE)

IgE antibodies attached to mast cells and basophils in the


bronchial walls
Mast cells degranulation

Mast cells releases chemical mediators of inflammation

Slow- reacting substance


Histamine bradykinin prostaglandins
anaphylaxis ( SRS- A)

Increase blood flow Increase mucus Chemical Contraction of the


to the area of insult production mediators induced bronchial smooth
capillary dilation muscles that encircles
the airway
(bronchospasm)
Edema of the
Deposition of
Attraction of WBC airway
collagen below the
to the area basement membrane
Airway constriction
or
Fluid shifting from bronchoconstriction
the vasculature
and to the alveoli

Hyperinflation of
alveoli

Narrowing of the airway

Increase work of breathing


Decreased elastic recoil
Increase resistance to airflow

Fatigue of the muscles of


ventilation
Ventilation- Perfusion (V/Q)
mismatch and shunt

Inadequate exchange of O2 and CO2

Hypoxemia

ACUTE RESPIRATORY
FAILURE

Recovery
COMPLICATIONS:
Tissue hypoxia
Subsequent organ
damage
Chronic respiratory failure
Tension pneumothorax
Lobar atelectasis
Death Pneumonia
` Pulmonary edema

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