COPD患者的镇静问题PPT演示课件.ppt

COPD患者应慎重应用镇静;1、COPD的镇静催眠问题； 2、长期口服镇静催眠药物的呼吸不良事件； 3、短期静脉应用镇静的心肺问题； 4、无创辅助通气时应用镇静的问题;;1、Up to 50% of their patients with COPD experience sleep abnormalities【1】. Dyspnea；cough and excessive mucus；the supine position；ventilator effort；nocturnal desaturations and hypercapnic episodes；drugs 2、Sleep-related complaints are ranked third complaints of patients with COPD【2】. 1、Stege G, Vos PJ, van den Elshout FJ, Richard DPN, van de Ven MJ, Heijdra YF. Sleep, hypnotics and chronic obstructive pulmonary disease. Respir Med. 2008. 102(6): 801-14. 2、Kinsman RA, Yaroush RA, Fernandez E, Dirks JF, Schocket M,Fukuhara J. Symptoms and experiences in chronic bronchitis and emphysema. Chest 1983;83:755–61.;seven studies with patients with COPD showed adverse respiratory effects associated with NBBRAs and benzodiazepines, where seven others did not. more adverse effects were seen with longer acting benzodiazepines. ;Limited duration. varying severity of COPD. Different pharmacodynamics various respiratory parameters1、Stege G, Vos PJ, van den Elshout FJ, Richard DPN, van de Ven MJ, Heijdra YF. Sleep, hypnotics and chronic obstructive pulmonary disease. Respir Med. 2008. 102(6): 801-14.;hypnotics, particularly benzodiazepines, should be avoided, if possibley,although there is evidence that some hypnotics, such aszolpidem, can be used in less severe COPD without significant adverse effects on gas exchange1. 1.Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–46. ;长期口服镇静催眠药物的呼吸不良事件 ;长期 催眠药物对慢性COPD患者的影响;;;hypnotics, especially in active users (0–30 days), is associated with an increased risk of adverse respiratory events in these COPD patients. This increased risk of adverse respiratory events emphasizes that evaluating the current insomnia treatments with hypnotics for these COPD patients is necessary and important. Clinicians should keep alert of the potential risk of adver