气道管理新进展课件

,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Covidien|,November 29,2018,|Confidential,Formerly Tyco Healthcare,#,|,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Covidien Respiratory&Monitoring Solutions|,November 29,2018,|Confidential,#,|,Covidien Respiratory&Monitoring Solutions|,November 29,2018,|Confidential,#,|,Click to edit Master title style,Were allowing the market,especially our competitors,to create the perception of who we are rather than taking the lead,Covidien Respiratory&Monitoring Solutions|,November 29,2018,|Confidential,#,|,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Covidien Respiratory&Monitoring Solutions|,November 29,2018,|Confidential,Formerly Tyco Healthcare,#,|,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,#,Covidien Respiratory&Monitoring Solutions|,11/29/2018,|Confidential,#,|,Click to edit Master title style,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Covidien Respiratory&Monitoring Solutions|,11/29/2018,|Confidential,#,|,Disclosure,Mark Procyshyn,RRT is the,Senior Regional Marketing Manager,for Covidiens Respiratory Division,in Asia.,DisclosureMark Procyshyn,R,What are postoperative pulmonary complications?,何为术后肺部并发症,What is their significance in terms of:,Incidence?,发生率？,Clinical outcomes?,临床结果？,Outline:,Outline:,Postoperative Pulmonary Complications,术后肺部并发症,These complications range from minor,self-limited conditions to major disease states with significant morbidity and mortality.,这些并发症小至自限性疾病，大至具有较高发病率和死亡率的疾病。,The most commonly cited examples in the clinical literature are:,1,在医学文献中最常见引用的并发症是：,Pneumonia,肺炎,Respiratory failure,呼吸衰竭,Atelectasis,肺不张,Acute exacerbation of chronic lung disease,慢性肺部疾病的急性加重,Other prominent examples include ARDS,bronchospasm,tracheobronchitis and perioperative hypoxia.,其他突出的并发症包括：,ARDS,，支气管痉挛，支气管炎，术中低氧血症,1.Arozullah,et al.Ann Surg.,2000;232(2):242-253.,Postoperative Pulmonary Compli,What are postoperative pulmonary complications?,何为术后肺部并发症,What is their significance in terms of:,Incidence?,发生率？,Clinical outcomes?,Outline:,What are postoperative pulmona,Postoperative Pulmonary Complications Are Surprisingly Common,术后肺部并发症十分常见,Surgical site,Reported,complication rate,Studies,n,AAA repair,腹主动脉瘤切除术,25.5%,16,Esophagectomy,食道切除术,18.9%,11,Abdominal surgery,腹部手术,14.2%,43,Head and neck surgery,头颈部手术,10.3%,6,Hip surgery,髋部手术,5.1%,5,Gynecologic/Urologic procedures,妇科,/,泌尿科操作,1.8%,2,1.Smetana,et al.Ann Intern Med.,2006;144:581-95.,Summary of studies investigating incidence of postoperative pulmonary complications by surgical site,as per systematic literature review in 2006,1,2006,年不同部位外科手术,后术后肺部并发症发生率研究的概要,Multiple studies show the high incidence of postoperative pulmonary complications.,多项研究先提示术后肺部并发症的发生率较高。,Postoperative Pulmonary Compli,Postoperative Pulmonary Complications Deserve Equal Attention with Perioperative Cardiac Complications,术后肺部并发症应与术中心脏并发症一样引起重视,Retrospective multicenter cohort study of 8,930 patients 60 years or older for hip surgery,1,针对,8930,例,60,岁以上髋部手术患者的多中心回顾性队列研究，,1.Lawrence,et al.Arch Intern Med,.2002.,Complication,Incidence,30-day mortality,1-year mortality,Serious cardiac*,严重的心血管疾病,2.0%,22%,36%,Serious pulmonary,严重的肺部疾病,2.6%,17%,44%,p-value:,-,0.05,0.05,*Definite or probable MI,emergency cardioversion,pacemaker insertion,ventricular fibrillation,ventricular tachycardia,hypotension requiring vasopressors,sick sinus syndrome or other conduction defect,or CPR.,Respiratory failure or pneumonia.,No statistical difference found for incidence or mortality at 30 days and 1 year.,30,天或,1,年的发病率或死亡率无显著性差异。,Postoperative Pulmonary Compli,In Aggregate,Postoperative Pulmonary Complications Occur More Often Than Cardiac,总体上，术后肺部并发症多于心脏并发症,Case control from 2,291 patients undergoing elective abdominal surgery,excluding atelectasis,1,2291,例进行择期腹部手术患者的病例对照研究，除外肺不张,Complication,Estimated incidence(95%CI),LOS(SD),p=0.001,Pulmonary,肺部,9.6%(7.2-12.0),22.5(17)days,Cardiac,心脏,5.7%(3.8-7.7),10.4(4.5)days,1.Lawrence,et al.J Gen Intern Med.,1995;10:671-678.,Total pulmonary complications occurred nearly twice as often and resulted in hospital lengths of stay over twice as long.,总的肺部并发症发生率高一倍，住院天数延长一倍多,In Aggregate,Postoperative Pu,Pneumonia,in Particular,Is Very Common in Surgical Patients,肺炎，外科患者尤为常见,Most common post-surgical complication in noncardiac surgical patients,1,非心脏手术患者最常见术后并发症,Most common complication in trauma patients,2,、,外伤患者最常见术后并发症,1.Khan,et al.J Gen Intern Med.,2006;21:177-180.,2.Hemmila,et al.Surgery.,2008;144:307-316.,Pneumonia,in Particular,Is V,What are postoperative pulmonary complications?,术后并发症,What is their significance in terms of:,Incidence?,Clinical outcomes?,临床结果？,Outline:,What are postoperative pulmona,Postoperative Pneumonia Confe