Respiratory Failure Bai Chunxue Department of Respiratory disease Zhongshan Hospital Fudan University Key Words Respiratory failure Acute respiratory distress syndrome(ARDS) dyspnea Hypoxemia hypercapnia  Respiratory Support Mechanical ventilation Positive end-expiratory pressure (PEEP) Respiratory Failure Definition Type I 、II Respiratory Failure Centrol 、Non-Centrol Respiratory  Failure Acute & Chronic Respiratory Failure ACUTE RESPIRATORY FAILURE Bai Chun-Xue Department of Respiratory diseases Zhongshan Hospital Definition respiratory dysfunction resulting in abnormalities of oxygenation or ventilation impair or threaten the function of vital organs Pathogeny Type I Parenchyma Edema Vascular disease Chest Wall & Pleural disease  Hypoxemia cyanosis, restlessness  confusion, anxiety, delirium  tachypnea, tachycardia  hypertension, cardiac arrhythmias tremor Hypercapnia Dyspnea and headache peripheral and conjunctiva hyperemia hypertension, tachycardia,tachypnea impaired consciousness papilledema, and asterixis Diagnosis PaO2<8 kPa PaCO2 >6.66 kPa Treatment specific therapy directed toward the underlying disease; respiratory supportive care directed toward the maintenance of adequate gas exchange; general supportive care. A. Respiratory Support Nonventilation 经鼻面罩机械通气治疗前后血气变化（X±S ）Ventilation Tracheal intubation–Indications Hypoxemia which is not quickly reversed by supplemental oxygen Airway obstruction Impaired airway protection Inadequate handling of secretions Facilitation of mechanical ventilation * * Chapter 7 复旦呼研所复旦呼研所Chapter 7 复旦呼研所复旦呼研所复旦呼研所Type II Airway obstruction Neuromuscular  disease 复旦呼研所hypoxemia Perfusion Diffusion Ventilation CO 2 CO 2 O 2 O 2 Clinical Findings 复旦呼研所PAO2 ，P ACO2 （kPa) hypercapnia CO2 O2 Clinical Findings 复旦呼研所复旦呼研所复旦呼研所复旦呼研所复旦呼研所Nonventilatory aspects  Ventilatory aspects 复旦呼研所SaO2 of ≥90% (PaO2 about 60 mm Hg). Hypoxemia in patients with obstructive airway disease is usual easily corrected by using low-flow oxygen by nasal cannula (1–3 L/min) or Venturi mask (24–28%). Higher concentrations of oxygen are necessary to correct hypoxemia in patients with ARDS, pneumonia, and other parenchymal lung diseases. 复旦呼研所白春学,等. 应用国产呼吸器经鼻面罩治疗慢性阻塞性肺病所致呼吸衰竭9例报告. 上海医学1993;16:102 复旦呼研所Tracheal intubation Mechanical ventilation  复旦呼研所