内科护理学课件 英语 考试资料Respiratory+Failure.ppt

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1、RespiratoryFailure呼吸衰竭RespiratoryFailureRespiratoryFailureisasyndromeinwhichtherespiratorysystemfailsinoneorbothofitsgasexchangefunction:oxygenation氧&carbondioxide二氧化碳elimination.PaO260mmHgorPaCO250mmHgAcuterespiratoryfailureispresentwhenalveolarventilationisinadequatelytomeetthebod

2、y’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通气减少bec

3、auseofpain.Theextremelyobese肥胖patientbecauseofrestrictionofventilation.Thepatientwhohassustainedathoracicorspinalcord脊髓injuryThecomatose昏迷patientorpatientwithdecreasedlevelofconsciousnessanddepressionoftherespiratorycenter.Thepatientwhohaslungdiseaseorwhosmokes,especiallywhenaninfecti

4、ondevelopsorsurgeryisneeded.Theimmunosuppressed免疫抑制patientsTheolderadultsChronicrespiratoryfailure-daysorlonger-pHisslightlydecreased;allowingtimeforrenalcompensationandanincreaseinbicarbonateconcentrationClassificationAcuterespiratoryfailure-minutesorhours-pH7.3TypeI:HypoxemiaRespir

5、atoryFailure低氧血症呼吸衰竭PaO260mmHgwithanormalorlowPaCO2Mostcommon:AssociatedtoallacutediseasesofthelungInvolvefluidfillingorcollapse塌陷ofalveoli(cardiogenicornoncardiogenicpulmonaryedema,pneumonia,hemorrhage出血)ClassificationTypeII:HypercapniaRespiratoryFailure高碳酸血症呼吸衰竭PaCO250mmHgwithhypo

6、xemia(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)mismatch通气血流比例失调Shunt

7、s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/Qrelationshipmeansthatwherethereisventilationinthelungs,there

8、mustb