【持续性肾脏替代治疗CRRT英文ppt课件】Nutrition Support of the Critically Ill Patient with Organ Failure.pptVIP

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【持续性肾脏替代治疗CRRT英文ppt课件】Nutrition Support of the Critically Ill Patient with Organ Failure.ppt

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【持续性肾脏替代治疗CRRT英文ppt课件】Nutrition Support of the Critically Ill Patient with Organ Failure

* 代理报关委托书委托报关协议关于审理城镇房屋租赁合同纠纷案件司法解释有关劳务派遣制度设计及对劳务派遣行业的影响分析糖皮质激素在呼吸系统疾病中的合理应用严重脓毒症导致急性肺损伤病人自发利尿现象的观察分析 * Nutrition Support of the Critically Ill Patient with Organ Failure Respiratory Failure Function of lungs: Move oxygen from air to venous blood and move carbon dioxide (CO2) out Important functional components of lung: Drive mechanism Muscles of respiration Alveoli Source: Hasse J. Nutrition and Organ Failure. In DNS. Sharpening Your Skills as a Nutrition Support Dietitian, 2003, p. 227 Acute Respiratory Failure Type 1: hypoxic respiratory failure. Low PaO2 with low to normal PaCO2 (PaO2/PaCO2 = partial pressure exerted by O2/CO2 dissolved in arterial plasma) Type 2: hypercapneic-hypoxic respiratory failure. Low PaO2 with increased PaCO2 Acute Respiratory Distress Syndrome (ARDS) PaO2:FiO2 ratio ≤ 200 (FiO2 = fraction of inspired oxygen, the % concentration of oxygen entering the lungs, ventilator or a blood oxygenator) Bilateral pulmonary infiltrates seen on X-ray PAW ≤ 15) mm/Hg PAW = pulmonary artery wedge pressure; normal is ≤ 12 mm/Hg Chronic Respiratory Failure Asthma COPD Bronchiectasis Cystic Fibrosis Infiltrative disease of the lung Pulmonary hypertension Treatment Goals for Respiratory Failure Treat underlying condition Support physiologic function Maintain tissue oxygen delivery Minimize pulmonary edema Give nutrition support Prevent/manage infection Source: Hasse J. Nutrition and Organ Failure. In DNS. Sharpening Your Skills as a Nutrition Support Dietitian, 2003, p. 227 Mechanical Ventilation Modes Assist control (AC) Intermittent mandatory ventilation Synchronized intermittent mandatory ventilation Mechanical Ventilation Settings CPAP: continuous positive airway pressure PEEP: positive end-expiratory pressure PEEP: A method of ventilation in which airway pressure is maintained above atmospheric pressure at the end of exhalation by means of a mechanical impedance, usually a valve, within the circuit. Purpose is to increase volume of gas remaining