呼吸衰竭.ppt

呼吸衰竭呼吸衰竭respiratory failurerespiratory failure呼吸过程?外呼吸(肺通气和肺换气)?气体在血液中的运输?内呼吸(组织换气)呼吸全过程概念与分类概念与分类1. 1. 呼吸功能不全(呼吸功能不全(respiratory insufficiencyrespiratory insufficiency))由于外呼吸功能严重障碍,以致机体在静息时不能维持足够的由于外呼吸功能严重障碍,以致机体在静息时不能维持足够的气体交换,导致动脉血氧分压降低伴(或不伴)动脉血二氧化气体交换,导致动脉血氧分压降低伴(或不伴)动脉血二氧化碳分压升高。碳分压升高。呼吸衰竭(Respiratory failure)一、概念与分类(一、概念与分类(concept & classification))没有明显的临床症状,但当体力负荷增加时没有明显的临床症状,但当体力负荷增加时PaOPaO22才明显降低才明显降低或伴有或伴有PaCOPaCO22水平增高。水平增高。((respiratory failurerespiratory failure))在海平面静息状态吸入空气的情况下,由于肺通气和(或)换气在海平面静息状态吸入空气的情况下,由于肺通气和(或)换气功能的严重障碍,以致功能的严重障碍,(<(<60mmHg60mmHg),),((50mmHg50mmHg))的病理过程。的病理过程。诊断标准:诊断标准:PaOPaO22< 60mmHg< 60mmHg((8kPa8kPa))with or without PaCOwith or without PaCO22 > 50mmHg > 50mmHg(())RFI = PaORFI = PaO22/FiO/FiO22≤≤ 300 300 Respiratory failure is a syndrome in which the respiratory system fails in one or both of its gas exchange functions: oxygenation and carbon dioxide elimination. In practice, respiratory failure is defined as a PaO2 value of less than 60 mm Hg while breathing air or a PaCO2 of more than 50 mm Hg. PO2Hb氧饱和度(%)33..分类(分类(classificationclassification))((11)按)按PaCOPaCO22分类(分类(according to ording to PaCO22))■■ⅠⅠ型呼吸衰竭型呼吸衰竭((hypoxemic respiratory failure)a PaO2 of less than 60 mm Hg with a normal or low PaCO2. Cause of:Edema, Vascular disease, Chest Wall & Pleural disease.■■ⅡⅡ型呼吸衰竭型呼吸衰竭((hypercapnic respiratory failure)a PaO2 low 60 mm Hg andPaCO2 of more than 50 mm Hg. Cause of:Airway obstruction, Neuromuscular ((44)按发病速度分类()按发病速度分类(according to ording to duration))■■急性呼吸衰竭(急性呼吸衰竭(acute respiratory acute respiratory failurfailur))..■■慢性呼吸衰竭(慢性呼吸衰竭(chronic respiratory failurechronic respiratory failure))..((33)按原发部位分类()按原发部位分类(according to primary according to primary sitesite))■■中枢性呼吸衰竭(中枢性呼吸衰竭(centralcentralrespiratory failurerespiratory failure)). . ■■非非中枢性呼吸