Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about respiratory support.

And you can find written notes on this topic at zero to finals.com slash respiratory support

or in the respiratory section of the second edition of the

Zero to Finals Medicine book. So let's get straight into it. There are several options for

supporting a patient's respiratory system when it's failing and these can be escalated as required.

From the least to the most invasive, the options are oxygen therapy,

high flow nasal cannula, non-invasive ventilation,

intubation and mechanical ventilation,

and extracorporeal membrane oxygenation, or ECMO. And we're going to talk about each one of

these in this topic. Additionally, chest physiotherapy and suction of secretions can be used to help

clear secretions and improve respiratory function. Respiratory support does not fix the underlying problem.

It just buys time while the underlying problem is managed and treated.

Let's start by talking about acute respiratory distress syndrome.

Acute respiratory distress syndrome, or ARDS, occurs due to a severe inflammatory reaction in the lungs,

often secondary to sepsis, for example pneumonia or COVID-19, or trauma to the lung tissue.

There is an acute onset or a rapid onset of collapse of the alveoli and the lung tissue

called atelectocysts, pulmonary edema not related to heart failure or fluid overload,

a decrease in lung compliance, which means there's reduced lung inflation when the lungs are

ventilated with a given pressure, and fibrosis of the lung tissue, typically occurring after

10 or more days of ARDS.

Clinically with ARDS, there is acute respiratory distress, hypoxia with an inadequate response to oxygen therapy,

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