休克及多重器官衰竭病人的處理课件.ppt

休克及多重器官衰竭病人的處理;大綱;1.心臟唧筒 2.循環血量 3.血管阻力;心臟生理 -- 前負荷 Preload - 心收縮力 Myocardial contractility - 後負荷 Afterload 心輸出量=心率 ×心搏容積 CO = HR x SV ;What is shock?;Classification;Hypovolemic shock;Hypovolemic shock Symptoms/Signs;Hypovolemic Shock Prevention;Hypovolemic Shock Diagnosis Tests; replacing blood and fluid volume. Intravenous fluids Dopamine, dobutamine, epinephrine, norepinephrine. cardiac monitoring, including Swan-Ganz placement of a urinary catheter to monitor urine output ;Cardiogenic Shock;Causes of ? CO;Cardiogenic Shock Diagnosis Tests;Cardiogenic Shock Treatment;Cardiogenic Shock Treatment-cont’d;Distributive Shock;Septic shock;Septic shock Risk factors;Septic shock Two phases:;Septic shock Diagnosis Tests;敗血性休克之輸液治療;敗血性休克之血管昇壓治療;Septic shock Treatment;Anaphylaxis shock;Neurogenic shock ;;休克病人的護理問題-1;休克病人的護理問題-2;休克病人的護理問題-3;休克病人的護理問題-4;休克病人的護理問題-5;休克病人的護理問題-6;休克病人的護理問題-7;休克病人的護理問題-8;休克病人的護理問題-9;休克病人的護理問題-10;;;;全身性發炎反應(SIRS) Systemic Inflammatory Response Syndrome :;Sepsis:;敗血症: 一個複雜的疾病;Severe Sepsis: ;敗血症之加護處理:;多重器官功能不良症候群 Multiple Organ Dysfunction Syndrome ( MODS );Jaundice ? Enzymes ? Albumin ? PT;Complications of MODS : ;Bone RC, Balk RA, Cerra FB, et al. Crit Care Med. 1992;20:864-874.;Nursing diagnosis for the patient with MODS;What ethical considerations play a role in the diagnosis of MODS?;Collaborative management measures for MODS;Future trends for the treatment of MODS ;