内科护理学课件 英语 考试资门料respiratory+failure.pptVIP

Respiratory Failure 呼吸衰竭 Respiratory Failure Respiratory Failure is a syndrome in which the respiratory system fails in one or both of its gas exchange function: oxygenation氧 carbon dioxide 二氧化碳 elimination. PaO2 ? 60 mmHg or PaCO2 ? 50 mmHg Acute respiratory failure is present when alveolar ventilation is inadequately to meet the body’s need; the lung can no longer adequately oxygenate the blood. Respiratory Failure Risk factor: The critically ill patient The patient who has undergone recent abdominal 腹部or thoracic胸部surgery, as a result of splinting夹板of the incision切口, abdominal distention, restrictive bandages绷带, tubes引流管, and reduced ventilation通气减少because of pain. The extremely obese肥胖patient because of restriction of ventilation. The patient who has sustained a thoracic or spinal cord脊髓injury The comatose昏迷patient or patient with decreased level of consciousness and depression of the respiratory center. The patient who has lung disease or who smokes, especially when an infection develops or surgery is needed. The immunosuppressed免疫抑制patients The older adults Mechanisms of type I respiratory failure Mechanisms that may cause hypoxemia and subsequent hypoxemic respiratory failure are: Ventilation-Perfusion (V/Q) mismatch通气血流比例失调 Shunts分流 Diffusion abnormalities弥散障碍 Alveolar ventilation肺泡通气不足 Mechanisms of type I respiratory failure Ventilation-Perfusion (V/Q) mismatch通气血流（V / Q )比例失调: alter (V/Q) relationship in the lungs or V/Q mismatch, is the most common cause of hypoxemia低氧血症. The V/Q relationship means that where there is ventilation in the lungs, there must be matching blood perfusion to that area for efficient gas exchange occur. In the normal lung the overall V/Q ratio is 0.8. Mechanisms of type I respiratory failure Ventilation-Perfusion (V/Q) mismatch An alteration or mismatch occurs if there is blood flow to areas of decrease or absent ventilation or if there is ventilation to areas of decrease or absent blood flow. Examples of process that caus