内科护理学课件 英语 考试资料Respiratory+Failure.ppt

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
atose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
Chronic respiratory failure
- days or longer
- pH is slightly decreased; allowing time for renal
compensation and an increase in bicarbonate
concentration
Classification
Acute respiratory failure
- minutes or hours
- pH 
Type I: Hypoxemia Respiratory Failure低氧血症呼吸衰竭

PaO2  60 mmHg with a normal or low PaCO2
mon:
Associated to all acute diseases of the lung
Involve fluid filling or collapse塌陷of alveoli (cardiogenic or noncardiogenic pulmonary edema, pneumonia, hemorrhage出血)
Classification
Type II: Hypercapnia Respiratory Failure高碳酸血症呼吸衰竭
PaCO2  50 mmHg with hypoxemia
(severe airway disorders . asthma, COPD, drug overdose吸毒过量, neuromuscular disease神经肌肉疾病, chest wall abnormalities胸壁畸形)
Classification
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
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