mods危重症的护理观察要点和方法sj0_z9ru.ppt

其结果是导致每搏输出量的减少而代偿性的使心率增快和MAP下降。 需高PEEP维持氧合, 腹腔减压术可迅速改善肺部变化。 In summary IAH decreases renal perfusion pressure, the filtration gradient, and renal blood flow. Oliguria develops, tubular dysfunction increases, glomerular filtration rate drops, renal vascular resistance increases, renal vein and ureter compression increases, renin, aldosteron and antidiuretic hormone levels increase, while adrenal blood flow usually remains preserved Burch等根据IAP和临床表现将IAH/ACS分为四级： J尽管仅根据IAP一点确定IAH是片面的，但是IAP的测量值仍然是非常重要的。 Figure 1. A closed needle-free revised method for measurement of intra-abdominal pressure. (a) A Foley catheter is connected to the urine collection bag with a ramp with 3 stopcocks. A standard intravenous (IV) infusion set is connected to a bag of 1000mL of saline and attached to the first stopcock. A 60-mL syringe is connected to the second stopcock and the third stopcock is connected to a pressure. The system is flushed and the pressure transducer is zeroed at the symphysis pubis. At rest the 3 stopcocks give an open way for urine flow. To measure IAP, the urinary drainage tubing is clamped and the third stopcock is turned ‘on’ to the transducer. The first stopcock is turned ‘off’ to the patient, the second stopcock is turned ‘on’ to the 60-mL syringe and 50ml of saline is aspirated into the syringe and instilled into the bladder. The third stopcock being turned ‘on’ to the transducer allows immediate IAP reading on the monitor. Reproduced with permission [1??]. (b) Mounted patient view of the device and close up of manifold and conical connection pieces. Reproduced with permission [1??]. 第15题 PH: 7.48 PCO2: 45mmHg PO2: 87mmHg HCO3-: 29mmol/L BE: 4.2mmol/L * 第16题 PH: 7.43 PCO2: 51mmHg PO2: 95mmHg HCO3-: 38mmol/L BE: 3.7mmol/L * 第17题 PH: 7.30 PCO2: 51mmHg PO2: 80mmHg HCO3-: 21mmol/L BE: -4.2mmol/L * 第18题 PH: 7.48 PCO2: 31mmHg PO2: 110mmHg HCO3-: 22.8mmol/