12.Respiratory Failure

Respiratory failure MBBS.weebly.com

Male, 32 Fever, cough with sputum for 3 days No finding on physical examination Diagnosis : pneumonia X － ray : shadow in left lower lobe August 16, 2003 August 20, 2003 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Intubation via mouth tracheotomy Monitoring and ventilation

Contents 0f outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]

Introduction (cont.) ,[object Object],[object Object],[object Object],[object Object]

Definition ,[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Respiratory Pump Failure （泵衰竭） ,[object Object],[object Object],[object Object]

Lung Failure （肺衰竭） ,[object Object],[object Object],[object Object],[object Object]

Mechanisms & Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mechanisms of hypoxemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],25 20 15 10 5 肺泡分压 (kPa) 0 2 4 6 8 10 肺泡通气量 (l/min) P A CO2 P A O2 P A C O 2 =0.863*VC O2 /VA

Mechanisms of hypoxemia –– Diffusion abnormality ( 弥散障碍 ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],100 80 60 40 动脉氧分压 0.25 0.5 0.75 血液通过肺泡毛细血管时间

Mechanisms of hypoxemia ,[object Object],[object Object],V/Q=0.8 V/Q>0.8 V/Q<0.8 Q > V (A-V shunt) Normal V > Q (dead space effect)

( 二 ) 通气 / 血流比例 V/Q 肺泡死腔通气 V/Q > 0.8 静 - 动脉分流 V/Q < 0.8 正常通气 / 血流 V/Q 0.8 VD PaCO 2 － PeCO 2 VT PaCO 2 Qs CcO 2 － CaO 2 Q T CcO 2 － CvO 2 V A 4.2L(R2.1, L2.1) Q 5.0L(R2.5, L2.5) 见于肺不张， ARDS 见于 COPD 正常 Mechanisms of hypoxemia

Mechanisms of hypoxemia ,[object Object],[object Object],800 100 20 10 肺泡氧分压 2 4 6 8 10 肺泡通气量 (l/min) 400 动脉氧分压 (kPa)

Mechanisms of hypercapnia ,[object Object],[object Object],[object Object]

Influence of hypoxemia Central nervous system ,[object Object],[object Object],[object Object],[object Object],[object Object]

Influence of hypoxemia Cardiovascular system ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Influence of hypoxemia Respiratory system

Influence of hypoxemia haematological system ,[object Object],[object Object]

Influence of hypoxemia Renal & Digestive system ,[object Object],[object Object]

Influence of hypercapnia Central nervous system ,[object Object],[object Object],[object Object],[object Object]

Influence of hypercapnia Cardiovascular system ,[object Object],[object Object],[object Object],[object Object],[object Object]

Influence of hypercapnia Respiratory system ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Influence of hypercapnia urinary system ,[object Object],[object Object],[object Object]

Influence of hypoxemia & hypercapnia Acid-base balance and electrolytes ,[object Object],[object Object],[object Object],[object Object],[object Object],pH = HCO 3 - PaCO 2

Clinical manifestation Acute respiratory failure (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation Acute respiratory failure (2)

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation Acute respiratory failure (3)

Clinical manifestation Chronic respiratory failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnostic criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnostic criteria The acute respiratory distress syndrome (ARDS) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment (outline of principle) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Etiology Management ,[object Object],[object Object],[object Object]

Causes of Upper Airway Obstruction ,[object Object],[object Object],[object Object],[object Object]

Treatment Keep airway open 保持气道通畅 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

A: Airway ( 气道通畅吗？ ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Maneuvers to Open the Airway ,[object Object],[object Object],[object Object]

Treatment Keep airway open 保持气道通畅 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Intubation Procedure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Intubation Procedure ,[object Object],[object Object],[object Object],[object Object]

B: Breathing 呼吸 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Barrier Breathing Devices 呼吸保护屏障装置

B: Breathing 呼吸 Airway Alternatives “ Fast-Trach” LMA (Laryngeal Mask Airway)

C: Circulation 循环 ,[object Object],[object Object],[object Object],[object Object]

D: Diagnosis 诊断 ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

Treatment Oxygen therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Oxygen therapy ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Treatment Oxygen therapy

Nasal cannula/prongs 鼻导管吸氧 ,[object Object]

Simple oxygen mask 常规面罩 ,[object Object],[object Object]

Venturi mask Venturi 面罩 ,[object Object]

Treatment Ensure adequate ventilation, correct CO2 retention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Non-invasive positive pressure ventilation, NIPPV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Different kind of masks 各款口鼻面罩

Treatment Mechanical ventilation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Management of electrolyte and acid-base disturbance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

12.Respiratory Failure

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

En vedette

En vedette (20)

Similaire à 12.Respiratory Failure

Similaire à 12.Respiratory Failure (20)

Plus de ghalan

Plus de ghalan (20)

Dernier

Dernier (20)

12.Respiratory Failure