肺和胃肠道症状：在生命的尽头的普通物理症状精选.pptVIP

Common Physical Symptoms at the End of Life: Pulmonary and GI Symptoms Mike Marschke, MD Mr. M - Chronic Smoker Mr. M, 78 YO, is a lifetime smoker. Dyspnea began 5 years ago. intubated twice in the past year. Since last admission 2 mos ago always needs 2-3 l/min nasal cannula oxygen, even at rest. He has lost 15 lbs, has a persistent cough, with gray phlegm He is on steroids and nebulizers What is Dyspnea? Subjective sense that you need to breath, that you ‘hunger air.’ Mechanism Respiratory Center of Medulla Chemo receptors sensing low O2, hi CO2 Mechano receptors (J receptors) in lun