山东大学基础医学院：《病理生理学 Pathophysiology》课程PPT教学课件（7年制）11 Respiratory Failure 呼吸衰竭

Respiratory Failure Zhang Xiao-ming Dept pathophysiology

1 Respiratory Failure Zhang Xiao-ming Dept. pathophysiology

男性.50岁,患喘息性支气管炎30年.三年来 常下肢浮肿三天前因受凉发煷咳嗽加重咳 黄痰.当日上午患者神志恍惚嗜睡.查:T38℃ 颈静脉充盈,肝大.双下肢凹陷性水肿,血气分 *T: pH7. 29, PaCo2 107kPa80mmHg), PaO2 7.33kPa(55mmHg).BE-5mmo血清钾 5.5mmol/L

2 男性, 50岁, 患喘息性支气管炎30年, 三年来 常下肢浮肿. 三天前因受凉发烧, 咳嗽加重, 咳 黄痰. 当日上午患者神志恍惚, 嗜睡. 查: T 38℃, 颈静脉充盈, 肝大, 双下肢凹陷性水肿. 血气分 析: pH7.29, PaCO2 10.7kPa(80mmHg), PaO2 7.33kPa(55mmHg). BE -5mmol/L血清钾 5.5mmol/L

ANATOMY OF THE LUNG Bronchi raced Capillari Back to Heart Blood From The Heart Intrapleural g space Alveolus

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RESPIRATION 4 distinct mechanisms. Ventilation Gas exchange J External respiration ansport of oxygen and carbon dioXide in the Internal respiration

4 RESPIRATION 4 distinct mechanisms: Ventilation Gas exchange External respiration Transport of oxygen and carbon dioxide in the blood Internal respiration

The Process of External Respiration PiO2 159mmHg Pulmonary ventilation PO, 102mImHg PCO, 40m/mH Pulmonary gas exchange Pao,40mmHg PaCo246mmHg PvO2 100mmHg Pv CO 40mmHs g

5 The Process of External Respiration Pulmonary gas exchange PiO2 159mmHg PAO2 102mmHg PACO2 40mmHg Pulmonary ventilation PaO2 40mmHg PaCO2 46mmHg PvO2 100mmHg PvCO2 40mmHg

Definition of rf Disorders of external respiratory function Pao250 mmHg 6. 67 kpa). judgment standard: PaO2 50 mmHg hypotonic hypoxia with(or without) respiratory acidosis

6 Definition of RF Disorders of external respiratory function PaO2 50 mmHg(6.67kpa). judgment standard: PaO2 50 mmHg hypotonic hypoxia with (or without) respiratory acidosis

respiratory insufficiency: It is a condition in which respiratory function is inadequate to meet body' s needs during exertion However, respiratory failure does so in rest a kind of respiratory insutticiency a severe respiratory insufficiency

7 respiratory insufficiency: It is a condition in which respiratory function is inadequate to meet body’s needs during exertion. However, respiratory failure does so in rest. a kind of respiratory insufficiency a severe respiratory insufficiency

Classification 1. According to blood gas 1) type I(hypoxemic RF): Pao2 50 mmHg(6.67 kpa

8 Classification 1. According to blood gas: 1) typeⅠ(hypoxemic RF) : PaO2 50 mmHg(6.67kpa)

2. According to primary site central peripheral 3. According to duration acute chronic

9 2. According to primary site central peripheral 3. According to duration acute chronic

Section 1 Causes and pathogenesis of respiratory failure

10 Section 1 Causes and pathogenesis of respiratory failure