氧供需平衡-麻醉课件PPT.pptVIP

氧供需平衡Balance of Oxygen Supply and Demand;氧输送 oxygen transport (O2T);氧瀑布 O2 Cascade;空气 ?上呼吸道 ;? 肺泡 ;Summary;The factors influence transport of oxygen;血红蛋白与氧的结合量;在组织内释放的氧量;摄氧率（utilization coefficient/oxygen extraction）;Physiological supply dependency;Pathological supply dependency;氧-血红蛋白解离曲线;Effects on Oxygen-Hemoglobin Dissociation Curve;The causes of a left-shifted oxy-Hb curve(P5027mmHg);The causes of a right-shifted oxy-Hb curve (P5027mmHg);氧供Oxygen delivery DO2;氧耗Oxygen consumption (VO2);氧需Oxygen demand;氧供需失衡时机体的代偿机制;Monitoring?;测定Hct及Hb的方法;SpO2 monitored by Pulse oximetry since 1980 SO2=O2Hb/(O2Hb+HHb)(%);Transcutaneous SpO2 monitoring;反射式脉搏氧饱和度探头;The esophageal probe (ESOX, ARISTO Medical, Chicago, IL);Blood gas tension measurement;Mixed venous blood oxygen saturation (SvO2);SvO2 monitoring;连续颈内静脉血氧饱和度监测;经气管混合静脉血氧饱和度监测;术中常用的CO监测方法;由动脉压力波形计算CO;PiCCO;术中TEE测量CO;;Calculation of the shunt fraction;Calculation of the shunt fraction;Calculation of the shunt fraction;氧供需平衡的监测;Gastric tonometry determines intraluminal PCO2 which is assumed to be in equilibrium with PCO2 in the gastric mucosa. Intramucosal pH (pHim) can be calculated by the Henderson-Hasselbach equation using the PCO2 value determined by gastric tonometry and the bicarbonate concentration in arterial blood.;决定DO2与VO2的因素;术中影响氧供的因素;缺氧; 氧治疗;The rules of oxygen treatment ;Oxygen therapy PaO260mmHg;Venturi mask. The colour of the mask’s aperture reflects the FiO2 achieved (24%: blue; 28%: white; 35%: yellow;40%: red; 60%: green);Complications;请讨论