白春学－呼吸衰竭.pptVIP

Respiratory Failure Bai Chunxue Department of Respiratory disease Zhongshan Hospital Fudan University Key Words Respiratory failure Acute respiratory distress syndrome(ARDS) dyspnea Hypoxemia hypercapnia Respiratory Support Mechanical ventilation Positive end-expiratory pressure (PEEP) Respiratory Failure Definition Type I、II Respiratory Failure Centrol、 Non-Centrol Respiratory Failure Acute Chronic Respiratory Failure ACUTE RESPIRATORY FAILURE Bai Chun-Xue Department of Respiratory diseases Zhongshan Hospital Definition respiratory dysfunction resulting in abnormalities of oxygenation or ventilation impair or threaten the function of vital organs Pathogeny Type I Parenchyma Edema Vascular disease Chest Wall Pleural disease Hypoxemia cyanosis, restlessness confusion, anxiety, delirium tachypnea, tachycardia hypertension, cardiac arrhythmias tremor Hypercapnia Dyspnea and headache peripheral and conjunctiva hyperemia hypertension, tachycardia,tachypnea impaired consciousness papilledema, and asterixis Diagnosis PaO28 kPa PaCO2 6.66 kPa Treatment specific therapy directed toward the underlying disease; respiratory supportive care directed toward the maintenance of adequate gas exchange; general supportive care. A. Respiratory Support Nonventilation 经鼻面罩机械通气治疗前后血气变化（X±S） Ventilation Tracheal intubation–Indications Hypoxemia which is not quickly reversed by supplemental oxygen Airway obstruction Impaired airway protection Inadequate handling of secretions Facilitation of mechanical ventilation * * Chapter 7 复旦呼研所 复旦呼研所 Chapter 7 复旦呼研所 复旦呼研所 复旦呼研所 Type II Airway obstruction Neuromuscular disease 复旦呼研所 hypoxemia Perfusion Diffusion Ventilation CO 2 CO 2 O 2 O 2 Clinical Findings 复旦呼研所 PAO2 ，P ACO2（kPa) hypercapnia CO2 O2 Clinical Findings 复旦呼研所 复旦呼研所 复旦呼研所 复旦呼研所 复旦呼研所 Nonventilatory aspects Ventilatory aspects 复旦呼研所 SaO2 of ≥90% (PaO2 about 60 mm Hg). Hypoxemia in patients with obstructive airway disease is usual easily