08休克3（08 shock 3）.docVIP

08休克3（08 shock 3） 6. in the late stage of shock, some patients with acute respiratory failure characterized by progressive hypoxemia and severe dyspnea were referred to as shock lung, which belonged to adult respiratory distress syndrome (ARDS). According to statistics, the shock lung accounts for about 1/3 of the cause of shock. The high mortality rate is due to acute injury of alveolar capillary membrane, make lung severe lesions showed severe interstitial and alveolar pulmonary edema, pulmonary congestion, pulmonary hemorrhage, limitation of atelectasis, pulmonary micro thrombosis and hyaline membrane formation. These lesions seriously affect the respiratory function and lead to acute respiratory failure. Manifested in: (1) the ratio of alveolar ventilation and blood flow is unbalanced. Because of the limitation of the lesion, localized atelectasis can lead to intrapulmonary shunt, and pulmonary DIC leads to dead cavity ventilation, which reduces PaO2. (2) gas diffusion disorder: pulmonary edema, pulmonary congestion, alveolar membrane thickening and hyaline membrane formation affect diffusion function. Because of the larger diffusion capacity of CO2 than oxygen, it shows a serious reduction of PaO2. (3) lung compliance decreased: pulmonary edema caused surfactant inactivation or dilution, increased alveolar surface tension, decreased lung compliance, and resulted in hypoventilation. (4) very serious, because of extensive lung pathological changes, make the lungs total air volume is reduced, besides hypoxemia, also have CO2 retention. (5) severe hypoxemia makes the patient suffer from respiratory distress and severe dyspnea. (6) acute respiratory failure caused by severe hypoxia, aggravate the shock caused by the low effective blood perfusion and hypoxia injury, increased cell damage and lead to organ dysfunction and failure, so the shock lung mortality rate is high, should actively control. 7.. Renal failure caused by shock can be divided into two types: functio