英国纽卡斯尔代写作业:低氧血症

2019-01-15 02:33

溺水的病理生理学与低氧血症和缺血性酸中毒继发的多器官效应密切相关。根据低氧血症和由此引起的酸中毒的程度，患者可能出现心脏骤停和中枢神经系统缺血。中枢神经系统损伤可能是由于溺水过程中所持续的低氧血症本身造成的，也可能是由于肺部损伤和随后的低氧血症造成的。伴随而来的头部或脊髓损伤可能导致额外的中枢神经损伤。虽然经常讨论淡水和咸水对电解质和液体失衡的渴望之间的差异，但它们很少对溺水附近的人具有临床意义。大多数患者吸入的液体少于4毫升/公斤。改变血容量需要11 ml/kg，在发生重大电解质变化之前，吸入量需要超过22 ml/kg。无论如何，大多数患者在出现时都是低血容量的，因为缺氧导致毛细血管通透性增加，导致血管内腔的液体流失。吞下大量的淡水可能导致低钠血症。
英国纽卡斯尔代写作业:低氧血症
The pathophysiology of near drowning is intimately related to the multiorgan effects secondary to hypoxemia and ischemic acidosis. Depending upon the degree of hypoxemia and resultant acidosis, the person may develop cardiac arrest and central nervous system (CNS) ischemia.CNS damage may occur because of hypoxemia sustained during the drowning episode per se or may occur secondarily because of pulmonary damage and subsequent hypoxemia. Additional CNS insult may result from concomitant head or spinal cord injury.Although differences observed between freshwater and saltwater aspirations in electrolyte and fluid imbalances are frequently discussed, they rarely of clinical significance for people experiencing near drowning. Most patients aspirate less than 4 ml/kg of fluid. 11 ml/kg is required for alterations in blood volume, and more than 22 ml/kg of aspiration is required before significant electrolyte changes develop. Regardless, most patients are hypovolemic at presentation because of increased capillary permeability from hypoxia resulting in losses of fluid from the intravascular compartment. Hyponatremia may develop from swallowing large amounts of fresh water.

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