Resuscitation for Respiratory Failure January 13, 1997

Resuscitation for Respiratory Failure January 13, 1997

PaO2 < 60 mmHg (8 kPa); PaCO2 > 50 mmHg (6.67 kPa). Common respiratory failure is usually triggered by pulmonary infection, and combination antibiotic therapy is generally the most appropriate approach (e.g., penicillin plus cephalosporins or aminoglycosides; penicillin plus gentamicin; if there is bacillary infection, amikacin or deoxykanamycin can be used; for Pseudomonas aeruginosa, cefradine is recommended). Oxygen administration (continuous low-flow oxygen inhalation).

Medications: Nicethamide 0.25–0.375 g per vial, 8–10 vials intravenously daily; lobeline 30–50 mg intravenously; AlmⅠrⅠn 50 mg twice daily to reduce CO2 partial pressure; aminophylline 0.1–0.25 g orally or intravenously; adrenal corticosteroids and salbutamol can also be used appropriately.

Respiratory failure may present with the following five types of acid-base imbalance: ① Respiratory acidosis: Due to carbon dioxide accumulation, improving ventilation is usually sufficient. If decompensated, alkaline medications are administered. ② Respiratory acidosis combined with metabolic acidosis. ③ Respiratory acidosis combined with metabolic alkalosis: Due to edema combined with heart failure and other factors, large doses of diuretics are used, leading to hypokalemia and hypochloremia, resulting in alkalosis. ④ Respiratory alkalosis: Caused by excessive ventilation and excessive carbon dioxide expulsion. ⑤ Hypokalemia and hypochloremia causing alkalosis.