患喘息性支气管炎.ppt
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5
Definition of RF
Disorders of external respiratory function
PaO2 <60 mmHg (8.0kpa) while breathing air at rest, with or without PaCO2 >50 mmHg(6.67kpa).
❖ thorax fluidify or pneumothorax
15
2. Obstructive hypoventilation :
central airway obstruction peripheral airway obstruction
16
1) central airway obstruction:
judgment standard: PaO2 <60 mmHg , PaCO2 >50 mmHg hypotonic hypoxia with (or without) respiratory acidosis
6
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.
4
The Process of External Respiration
PiO2 159mmHg
Pulmonary ventilation
Pulmonary gas exchange
PAO2 102mmHg PACO2 40mmHg
PvO2 100mmHg PvCO2 40mmHg
PaO2 40mmHg PaCO2 46mmHg
2
3
RESPIRATION 4 distinct mechanisms:
Ventilation Gas exchange External respiration Transport of oxygen and carbon dioxide in the blood Internal respiration
13
component elements causing ventilation disturbance
Airway straitness or block
Inhibition of R. center
High spinal cord damaged
Anterior angle cell damaged
8
2. According to primary site central peripheral
3. According to duration acute chronic
9
Section 1 Causes and pathogenesis of
respiratory failure
10
• Pathogenesis of RF:
a kind of respiratory insufficiency a severe respiratory insufficiency
7
Classification
1. According to blood gas: 1) typeⅠ(hypoxemic RF) : PaO2 <60 mmHg (8.0kpa) 2) type Ⅱ (hypercapnic RF) : PaO2 <60 mmHg (8.0kpa) , with PaCO2 >50 mmHg(6.67kpa)
above the forfication (between the glottis and the carina) obstruction locates out of thorax（ paralysis, edema
weakness of R. M
phrenic nerve damaged
thorax wall damaged
Lung elastic resistance increased
14
பைடு நூலகம்
1. Restrictive hypoventilation:
Causes and mechanisms:
❖ impaired activity of respiratory muscle (dysfunction of CNS, neural, muscle etc.)
❖ decreased compliance of thorax (chest malformation , pleura fibrosis)
❖ decreased compliance of lungs (pulmonary edema , inflammation , fibrosis, insufficient surfactant)
Respiratory Failure
Zhang Xiao-ming Dept. pathophysiology
1
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.
restrictive hypoventilation obstructive hypoventilation
12
• Causes of RF
Disorders of:
Central Nervous System Spinal Cord Neuromuscular System the chest wall and pleura the airway
Disorders of external respiratory function pulmonary ventilation disturbance pulmonary gas exchange disturbance
11
Ⅰ.pulmonary ventilation disturbance i. Types and Causes
Definition of RF
Disorders of external respiratory function
PaO2 <60 mmHg (8.0kpa) while breathing air at rest, with or without PaCO2 >50 mmHg(6.67kpa).
❖ thorax fluidify or pneumothorax
15
2. Obstructive hypoventilation :
central airway obstruction peripheral airway obstruction
16
1) central airway obstruction:
judgment standard: PaO2 <60 mmHg , PaCO2 >50 mmHg hypotonic hypoxia with (or without) respiratory acidosis
6
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.
4
The Process of External Respiration
PiO2 159mmHg
Pulmonary ventilation
Pulmonary gas exchange
PAO2 102mmHg PACO2 40mmHg
PvO2 100mmHg PvCO2 40mmHg
PaO2 40mmHg PaCO2 46mmHg
2
3
RESPIRATION 4 distinct mechanisms:
Ventilation Gas exchange External respiration Transport of oxygen and carbon dioxide in the blood Internal respiration
13
component elements causing ventilation disturbance
Airway straitness or block
Inhibition of R. center
High spinal cord damaged
Anterior angle cell damaged
8
2. According to primary site central peripheral
3. According to duration acute chronic
9
Section 1 Causes and pathogenesis of
respiratory failure
10
• Pathogenesis of RF:
a kind of respiratory insufficiency a severe respiratory insufficiency
7
Classification
1. According to blood gas: 1) typeⅠ(hypoxemic RF) : PaO2 <60 mmHg (8.0kpa) 2) type Ⅱ (hypercapnic RF) : PaO2 <60 mmHg (8.0kpa) , with PaCO2 >50 mmHg(6.67kpa)
above the forfication (between the glottis and the carina) obstruction locates out of thorax（ paralysis, edema
weakness of R. M
phrenic nerve damaged
thorax wall damaged
Lung elastic resistance increased
14
பைடு நூலகம்
1. Restrictive hypoventilation:
Causes and mechanisms:
❖ impaired activity of respiratory muscle (dysfunction of CNS, neural, muscle etc.)
❖ decreased compliance of thorax (chest malformation , pleura fibrosis)
❖ decreased compliance of lungs (pulmonary edema , inflammation , fibrosis, insufficient surfactant)
Respiratory Failure
Zhang Xiao-ming Dept. pathophysiology
1
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.
restrictive hypoventilation obstructive hypoventilation
12
• Causes of RF
Disorders of:
Central Nervous System Spinal Cord Neuromuscular System the chest wall and pleura the airway
Disorders of external respiratory function pulmonary ventilation disturbance pulmonary gas exchange disturbance
11
Ⅰ.pulmonary ventilation disturbance i. Types and Causes