The negative pressure created in the thorax during inspiration leads to subatmospheric pressure in the alveoli, creating a gradient for the flow of inspired air toward the alveoli. Contraction of the respiratory muscles creates negative pleural pressure by expanding the chest cavity and pushing the abdominal contents down.Thoracic cage and respiratory muscles (bellows).The neural impulses from the central nervous system traverse the spinal cord and motor neurons, reaching and activating the diaphragm and other respiratory muscles.Central neurons (in medulla) which control rate, depth and pattern of breathing upon information which is received from central and peripheral receptors.The respiration (ventilation) is governed by the integrated function of respiratory apparatus which is composed of the following compartments (figure 3):.In the following figure a general view on O 2 and CO 2 transport cascaded is illustrated (figure 1) 1 2.In the following discussion the basic physiology of gas exchange and signs and symptoms of respiratory distress are explored. Before a deep dive into management of these critical patients, the groundwork should be laid. This represents a life-threatening group of disorders for which inadequate management may lead to rapid clinical deterioration. Patients with respiratory Failureare in extremes with severe respiratory distress and profound derangement in arterial oxygenation or CO 2 elimination. Respiratory distress is a clinical term and refers to the patient’s subjective sensation of dyspnea with signs indicating difficulty breathing (i.e. Pathophysiology and etiology of hypercapnia.Pathophysiology and etiology of hypoxemia.Ventilation and perfusion relationship (V/Q).
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