内科学呼吸衰竭ppt课件.pptVIP

Respiratory failure;Male, 32 Fever, cough with sputum for 3 days No finding on physical examination Diagnosis: pneumonia X－ray: shadow in left lower lobe ;Intubation via mouth tracheotomy;Contents 0f outline;Introduction ;Introduction (cont.);Definition ;Classification;Classification;Etiology;Respiratory Pump Failure（泵衰竭）;Lung Failure（肺衰竭）;Mechanisms Pathophysiology;;Mechanisms of hypoxemia;Mechanisms of hypoxemia –– Diffusion abnormality (弥散障碍);Mechanisms of hypoxemia;(二)通气/血流比例 V/Q;Mechanisms of hypoxemia;Mechanisms of hypercapnia;Influence of hypoxemia Central nervous system ;Influence of hypoxemiaCardiovascular system;PaO2↓ (60mmHg) →stimulate the chemoreceptors → stimulate respiratory center → strengthen respiratory movement, MV ?, respiratory distress PaO2↓(30mmHg)→inhibition of respiratory centerstimulation of respiratory center → respiratory depression Hyperventilation→CO2↓→inhibition of respiratory center Severe hypoxemia → slow shallow irregular respiration or Cheyne-Stokes respiration;Influence of hypoxemiahaematological system ;Influence of hypoxemiaRenal Digestive system;Influence of hypercapnia Central nervous system;Influence of hypercapnia Cardiovascular system;Influence of hypercapnia Respiratory system;pH?;Influence of hypercapniaurinary system;Influence of hypoxemia hypercapniaAcid-base balance and electrolytes;Clinical manifestationAcute respiratory failure (1);Cyanosis: Cyanosis is a typical sign of hypoxia, indicating arterial oxygen saturation lower than 90%. The extent of cyanosis is associated with content of reduced hemoglobin. So it is less readily detectable if anemia is present and more readily seen in polycythemia. Peripheral cyanosis is associated with stasis, in which oxyhemoglobin is reduced more than it normally is because of the prolonged peripheral blood transit time, while the PaO2 could be normal. Central cyanosis results from arterial hypoxemia.;Neuropsychic symptoms: Mental disorder, mania, coma, convulsi