呼吸机应用基础题稿.ppt

  1. 1、本文档共131页,可阅读全部内容。
  2. 2、有哪些信誉好的足球投注网站(book118)网站文档一经付费(服务费),不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
  3. 3、本站所有内容均由合作方或网友上传,本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺!文档内容仅供研究参考,付费前请自行鉴别。如您付费,意味着您自己接受本站规则且自行承担风险,本站不退款、不进行额外附加服务;查看《如何避免下载的几个坑》。如果您已付费下载过本站文档,您可以点击 这里二次下载
  4. 4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“版权申诉”(推荐),也可以打举报电话:400-050-0827(电话支持时间:9:00-18:30)。
查看更多
* 处理: 1、气管插管接呼吸机,A/C(PC+PEEP)或SIMV+PSV+PEEP. 辅助呼吸原则:小潮气,小-中剂量PEEP 即:潮气量=5-8ml/Kg,R=12-18 PEEP=5-15cmH2O 2、加强胸部外固定,使用有强心作用的血管活性药(中剂量多巴胺+小剂量多巴酚丁胺),纠正低蛋白血症,监测CVP,增加容量,适用利尿剂,镇静镇痛 * 2天后复查胸片,患者肺部情况较前清晰,胸腔积液少许 逐渐减少呼吸频率,降低FiO2和peep,降低PSV,SPO2 98%,f 16bpm 处理:改CPAP(SPONT),3天后,CPAP降为4cmH2O,患者咳嗽有力,痰少,引流量少,开放脱机 脱机4h,患者无不适,拔管。 * 4天后,患者胸部骨折处疼痛,咳嗽乏力,咳痰困难,氧饱和度稍低86-90%,呼吸频率稍快, 处理:协助咳痰,镇痛,雾化,使用氨溴索等。无创呼吸机辅助通气(SPONT模式) 5天后,顺利脱机 * 掌握机械通气的唯一捷径 ——勤学苦练 * 呼吸机只是一个辅助手段。 学习呼吸机,重在实践。 * Standard care of the patient with severe sepsis consists of a number of medical (and sometimes surgical) interventions intended to normalize physiology and eliminate infection. These are divided into: Source control: This term refers to management of the source of the infection. It can consist of surgery to drain an abscess or removal of an infected catheter. Antibiotics: While the initial therapy may be broad-based and empiric, identification of the specific pathogen by microbiologic studies may result in a switch of the antibiotic to those that are the most specific and bacteriocidal. Hemodynamic support: This term refers to volume replenishment therapy followed, when necessary, by appropriate use of drugs such as norepinephrine to maintain blood pressure and organ perfusion. Mechanical ventilation: Respiratory failure is a common manifestation of pulmonary organ dysfunction in patients with severe sepsis. Mechanical ventilation is instituted to increase oxygenation and improve gas exchange. Renal replacement therapy: Impaired renal function is a sign of organ dysfunction in patients with severe sepsis. Renal replacement therapy consists of temporary hemodialysis or ultrafiltration. Sedation and analgesia: Sedation is often required to treat anxiety and agitation in patients with severe sepsis. Because these patients are at risk for pain and physical discomfort, analgesics also are commonly employed. Ensure adequate nutrition: Sepsis is a hypercatabolic state. Therefore, caloric and nitro

您可能关注的文档

文档评论(0)

希望之星 + 关注
实名认证
内容提供者

该用户很懒,什么也没介绍

1亿VIP精品文档

相关文档