吸氧疗法-氧疗课件完整版

1、Small D, Duha A, Wieskopf B, et al. Uses and misuses of oxygen in hospitalized patients. Am J Med 1992; 92: 591-595Bateman NT, Leach RM. ABC of oxygen: acute oxygen therapy. BMJ 1998;317:798-801在静息患者在静息患者, 即使呼吸功能衰竭即使呼吸功能衰竭导致最严重的临床低氧血症导致最严重的临床低氧血症,也不会引起全身组织厌氧代谢也不会引起全身组织厌氧代谢动脉氧分压氧输送Bateman NT, Leach R

2、M. ABC of oxygen: acute oxygen therapy. BMJ 1998;317:798-801Tidal volume500 mlwithin 1 secAnatomic reservoir100% oxygen50 mlCannula flow rate100% oxygen100 mlRoom air20% oxygen350 mlFiO2= 220 ml O2 / 500 ml= 0.44Bateman NT, Leach RM. ABC of oxygen: acute oxygen therapy. BMJ 1998;317:798-801FiO2 = 0.

3、21 + 0.04 x 氧流量氧流量(lpm)?Tidal volume250 mlwithin 1 secAnatomic reservoir100% oxygen50 mlCannula flow rate100% oxygen100 mlRoom air20% oxygen100 mlFiO2= 170 ml O2 / 250 ml= 0.68Bateman NT, Leach RM. ABC of oxygen: acute oxygen therapy. BMJ 1998;317:798-801Bateman NT, Leach RM. ABC of oxygen: acute ox

4、ygen therapy. BMJ 1998;317:798-801Bernoulli effect1/2 2 + p = constant: 密度: 速度p: 压力吸入氧浓度不受患者呼吸形式的影响气流流速 最大吸气流速呼吸肌肉力量减弱呼吸肌肉力量减弱 颅内病变颅内病变(头颅创伤头颅创伤和药物过量和药物过量) 神经肌肉接头病变神经肌肉接头病变(重症重症肌无力肌无力, Guillain-Barre,神经原病神经原病) 肌肉病变肌肉病变(严重低钾严重低钾)呼吸肌肉负荷增加呼吸肌肉负荷增加 阻力增加阻力增加(气道梗阻气道梗阻) 顺应性降低顺应性降低(感染感染,水肿水肿, 肋骨骨折肋骨骨折, 肥胖肥胖

5、) 任何原因引起的呼吸任何原因引起的呼吸频率加快频率加快Robinson TD, Freiberg DB, Regnis JA, Young IH. The role of hypoventilation and ventilation-perfusion redistribution in oxygen-induced hypercapnia during acute exacerbations of COPD. Am J Respir Crit Care Med 2000; 161: 1524-1529.Nasal cannulaSimple facemaskMask with reservoir bag (non-rebreathing