COPD患者的镇静问题ppt.ppt

COPD患者应慎重应用镇静 1 COPD的镇静催眠问题 2 长期口服镇静催眠药物的呼吸不良事件 3 短期静脉应用镇静的心肺问题 4 无创辅助通气时应用镇静的问题 COPD与睡眠 1 Upto50 oftheirpatientswithCOPDexperiencesleepabnormalities 1 Dyspnea coughandexcessivemucus thesupineposition ventilatoreffort nocturnaldesaturationsandhypercapnicepisodes drugs2 Sleep relatedcomplaintsarerankedthirdcomplaintsofpatientswithCOPD 2 1 StegeG VosPJ vandenElshoutFJ RichardDPN vandeVenMJ HeijdraYF Sleep hypnoticsandchronicobstructivepulmonarydisease RespirMed 2008 102 6 801 14 2 KinsmanRA YaroushRA FernandezE DirksJF SchocketM FukuharaJ Symptomsandexperiencesinchronicbronchitisandemphysema Chest1983 83 755 61 sevenstudieswithpatientswithCOPDshowedadverserespiratoryeffectsassociatedwithNBBRAsandbenzodiazepines wheresevenothersdidnot moreadverseeffectswereseenwithlongeractingbenzodiazepines Limitedduration varyingseverityofCOPD Differentpharmacodynamicsvariousrespiratoryparameters1 StegeG VosPJ vandenElshoutFJ RichardDPN vandeVenMJ HeijdraYF Sleep hypnoticsandchronicobstructivepulmonarydisease RespirMed 2008 102 6 801 14 hypnotics particularlybenzodiazepines shouldbeavoided ifpossibley althoughthereisevidencethatsomehypnotics suchaszolpidem canbeusedinlesssevereCOPDwithoutsignificantadverseeffectsongasexchange1 1 CelliBR MacNeeW StandardsforthediagnosisandtreatmentofpatientswithCOPD asummaryoftheATS ERSpositionpaper EurRespirJ2004 23 932 46 长期口服镇静催眠药物的呼吸不良事件 长期催眠药物对慢性COPD患者的影响 ChungWS LaiCY LinCL KaoCH AdverseRespiratoryEventsAssociatedWithHypnoticsUseinPatientsofChronicObstructivePulmonaryDisease APopulation BasedCase ControlStudy Medicine Baltimore 2015 94 27 e1110 ChungWS LaiCY LinCL KaoCH AdverseRespiratoryEventsAssociatedWithHypnoticsUseinPatientsofChronicObstructivePulmonaryDisease APopulation BasedCase ControlStudy Medicine Baltimore 2015 94 27 e1110 ChungWS LaiCY LinCL KaoCH AdverseRespiratoryEventsAssociatedWithHypnoticsUseinPatientsofChronicObstructivePulmonaryDisease APopulation BasedCase ControlStudy Medicine Baltimore 2015 94 27 e1110 hypnotics especiallyinactiveusers 0 30days isassociatedwithanincreasedriskofadverserespiratoryeventsintheseCOPDpatients ThisincreasedriskofadverserespiratoryeventsemphasizesthatevaluatingthecurrentinsomniatreatmentswithhypnoticsfortheseCOPDpatientsisnecessaryandimportant CliniciansshouldkeepalertofthepotentialriskofadverserespiratoryeventsintheseCOPDpatientsbeforeprescribinghypnotics ChungWS LaiCY LinCL KaoCH AdverseRespiratoryEventsAssociatedWithHypnoticsUseinPatientsofChronicObstructivePulmonaryDisease APopulation BasedCase ControlStudy Medicine Baltimore 2015 94 27 e1110 2020 3 19 13 可编辑 COPD患者的短期临床镇静 短期镇静对高龄COPD患者心肺功能的影响 XuCX ChenX JiaY etal Stepwisesedationforelderlypatientswithmild moderateCOPDduringuppergastrointestinalendoscopy WorldJGastroenterol 2013 19 29 4791 8 XuCX ChenX JiaY etal Stepwisesedationforelderlypatientswithmild moderateCOPDduringuppergastrointestinalendoscopy WorldJGastroenterol 2013 19 29 4791 8 XuCX ChenX JiaY etal Stepwisesedationforelderlypatientswithmild moderateCOPDduringuppergastrointestinalendoscopy WorldJGastroenterol 2013 19 29 4791 8 无创辅助通气中的镇静问题 XuCX ChenX JiaY etal Stepwisesedationforelderlypatientswithmild moderateCOPDduringuppergastrointestinalendoscopy WorldJGastroenterol 2013 19 29 4791 8 小结 COPD患者普遍存在有睡眠问题 提高生活质量指数可能会遇到镇静安眠问题