RespiratoryFailure呼吸衰竭RespiratoryFailureRespiratoryFailureChronicrespiratoryfailure-daysorlonger-pHisslightlydecreased;allowingtimeforrenalcompensationandanincreaseinbicarbonateconcentrationTypeI:HypoxemiaRespiratoryFailure低氧血症呼吸衰竭PaO260mmHgwithanormalorlowPaCO2Mostcommon:AssociatedtoallacutediseasesofthelungInvolvefluidfillingorcollapse塌陷ofalveoli(cardiogenicornoncardiogenicpulmonaryedema,pneumonia,hemorrhage出血)TypeII:HypercapniaRespiratoryFailure高碳酸血症呼吸衰竭PaCO250mmHgwithhypoxemia(severeairwaydisorderse.g.asthma,COPD,drugoverdose吸毒过量,neuromusculardisease神经肌肉疾病,chestwallabnormalities胸壁畸形)MechanismsoftypeIrespiratoryfailureMechanismsoftypeIrespiratoryfailureMechanismsoftypeIrespiratoryfailureMechanismsoftypeIrespiratoryfailureMechanismsoftypeIrespiratoryfailureMechanismsoftypeIrespiratoryfailureMechanismsoftypeIrespiratoryfailurePathophysiologiceffectsofhypoxemiaPathophysiologiceffectsofhypoxemiaMechanismsoftypeIIrespiratoryfailureMechanismsoftypeIIrespiratoryfailureMechanismsoftypeIIrespiratoryfailurePathophysiologiceffectsofhypercapniaPathophysiologiceffectsofhypercapniaPathophysiologiceffectsofhypercapniaClinicalmanifestation临床表现Clinicalmanifestation临床表现Diagnosticstudies辅助检查Nursingimplementation护理措施NursingimplementationNursingimplementationNursingimplementationNursingimplementationNursingimplementationNursingimplementationNursingimplementationImprovementofalveolarventilation5.Reliefofbronchospasm减轻支气管痉挛Bronchodilators支气管扩张剂Reliefofbronchospasm(ifpresent)willaidinmaximalbronchodilatationandincreaseeffectivealveolarventilation.AdministrationofanO2-richedgasmixturesimultaneouslywiththebronchodilatormayhelptoalleviatethesubsequentlyhypoxemia.Corticosteroids(whenindicated)Corticosteroidsareusedinconjunctionwithbronchodilatingagentswhenbronchospasmandinflammationarepresent.NursingimplementationNursingimplementationNursinginterventionandrationalesNursinginterventionandrationalesNursinginterventionandrationalesNursinginterventionandrationales