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1、萬用卡RespiratoryFailureThedepartmentofpathophysiologySUNHuilanO2CO2CO2ExternalrespirationcirculationInternalrespirationWhatisrespiratoryfailureRespiratoryfailureisapathologicalprocessInwhichtheexternalrespiratorydysfunctionleadstoanabnormaldecreaseofarterialpartialpressureofoxygenwithorwithoutcarb
2、ondioxideretention.HowtoJudgerespiratoryfailure（1）PaO2<8kpa（60mmHg）（2）PaCO2>6.6kpa（50mmHg）classificationofRF：Hypoxemic(GroupⅠ）RF——（1）Hypercapnic（GroupⅡ）RF——（1）＋（2）EtiologyandPathogenesisofRFVentilatorydisordersDiffusiondisordersVentilation-perfusionimbalanceAnatomicshuntEtiologyandPathogenesisof
3、RF(1)VentilatorydisorderRestrictiveVentilatorydisordersObstructiveVentilatorydisordersRestrictiveVentilatorydisordersParalysisoftherespiratoymusclesDecreasedcomplianceofchestwallDecreasedcomplianceoflungsHydrothoraxorpneumothoraxEtiologyandPathogenesisofRF(1)大腦皮層——調(diào)節(jié)呼吸肌作隨意運(yùn)動腦橋、延髓——不隨意的自主節(jié)律呼吸調(diào)節(jié)脊髓
4、肋間神經(jīng)肋間肌肋骨、胸骨隔肌胸膜及胸膜腔胸廓外傷、中毒出血、感染脊髓灰質(zhì)炎、高位截癱多發(fā)性神經(jīng)炎重癥肌無力、多發(fā)性肌炎大量腹水、上腹巨大腫物外傷、骨折氣胸、大量胸腔積液EtiologyandPathogenesisofRF(1)CentralairwayobstructionPeripheralairwayobstructionObstructiveVentilatorydisordersO2CO2CO2O2口鼻喉頭肺泡氣管、支氣管肺泡膜肺血管意外異物水腫炎癥異物異物腫瘤哮喘肺水腫肺泡癌炎癥纖維化間質(zhì)水腫休克栓塞CentralairwayobstructionPeripheralair
5、wayobstructionExtrathoracicvariableobstructionexpirationinspirationIntrathoracicvariableobstructionexpirationinspirationnomalChronicbronchitisemphysema＋20＋30＋20＋350＋10＋200＋10＋20＋20＋20＋25＋20＋20＋20＋20PeripheralairwayobstructionBloodgasLowPaO2andHighPaCO2VentilatorydisordersO2CO2CO2O2口鼻喉頭肺泡氣管、支氣管肺泡
6、膜肺血管意外異物水腫炎癥異物異物腫瘤哮喘肺水腫肺泡癌炎癥纖維化間質(zhì)水腫休克栓塞EtiologyandPathogenesisofRF(2)Areaofalveolar-capillarymembrane↓DiffusiondisordersThicknessofalveolar-capillarymembrane↑Exchengetime↓O2CO2alveolar-capillarymembranesurfactantAlveolarepitheliumCapillaryendotheliocyteBloodgasLowPaO2andnomalPaCO2Diffusiondisord
7、ersEtiologyandPathogenesisofRF(3)LocalhypoventilationVA/Q↓FunctionalshuntLocalhypoperfusionVA/Q↑DeadspacelikeventilationVentilation-perfusionimbalanceBloodgasLowPaO2andNomalorloworhighPaCO2Ventilation-perfusionimbalanceBlood
