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ID:43619447
大小:993.00 KB
页数:46页
时间:2019-10-11
《内科护理学课件英语考试资料Respiratory+Failure》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、RespiratoryFailure呼吸衰竭RespiratoryFailureRespiratoryFailureisasyndromeinwhichtherespiratorysystemfailsinoneorbothofitsgasexchangefunction:oxygenation氧&carbondioxide二氧化碳elimination.PaO260mmHgorPaCO250mmHgAcuterespiratoryfailureispresentwhenalveolarventilationisinadequatelytomeetthe
2、body’sneed;thelungcannolongeradequatelyoxygenatetheblood.RespiratoryFailureRiskfactor:ThecriticallyillpatientThepatientwhohasundergonerecentabdominal腹部orthoracic胸部surgery,asaresultofsplinting夹板oftheincision切口,abdominaldistention,restrictivebandages绷带,tubes引流管,andreducedventilation通
3、气减少becauseofpain.Theextremelyobese肥胖patientbecauseofrestrictionofventilation.Thepatientwhohassustainedathoracicorspinalcord脊髓injuryThecomatose昏迷patientorpatientwithdecreasedlevelofconsciousnessanddepressionoftherespiratorycenter.Thepatientwhohaslungdiseaseorwhosmokes,especiallywhen
4、aninfectiondevelopsorsurgeryisneeded.Theimmunosuppressed免疫抑制patientsTheolderadultsChronicrespiratoryfailure-daysorlonger-pHisslightlydecreased;allowingtimeforrenalcompensationandanincreaseinbicarbonateconcentrationClassificationAcuterespiratoryfailure-minutesorhours-pH7.3TypeI:Hyp
5、oxemiaRespiratoryFailure低氧血症呼吸衰竭PaO260mmHgwithanormalorlowPaCO2Mostcommon:AssociatedtoallacutediseasesofthelungInvolvefluidfillingorcollapse塌陷ofalveoli(cardiogenicornoncardiogenicpulmonaryedema,pneumonia,hemorrhage出血)ClassificationTypeII:HypercapniaRespiratoryFailure高碳酸血症呼吸衰竭PaCO2
6、50mmHgwithhypoxemia(severeairwaydisorderse.g.asthma,COPD,drugoverdose吸毒过量,neuromusculardisease神经肌肉疾病,chestwallabnormalities胸壁畸形)ClassificationMechanismsoftypeIrespiratoryfailureMechanismsthatmaycausehypoxemiaandsubsequenthypoxemicrespiratoryfailureare:Ventilation-Perfusion(V/Q)mis
7、match通气血流比例失调Shunts分流Diffusionabnormalities弥散障碍Alveolarventilation肺泡通气不足MechanismsoftypeIrespiratoryfailureVentilation-Perfusion(V/Q)mismatch通气血流(V/Q)比例失调:alter(V/Q)relationshipinthelungsorV/Qmismatch,isthemostcommoncauseofhypoxemia低氧血症.TheV/Qrelationshipmeansthatwherethereisventil
8、ationinthelungs,theremustb
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