COVID-19病人的組織缺氧和呼吸衰竭(Hypoxia and lung failure in COVID-19):
在大部份的COVID-19的病人,組織缺氧(hypoxia)是COVID-19的病人主要的和最嚴重的症徵症狀。
維持足夠的氧氣供應釋出的補償機轉,包括
增加呼吸做功(increase respiratory effort),
缺氧性的血管縮收(hypoxic vasocontriction),以及
增加心輸出量(increase cardiac output)。
隨著COVID-19病人的嚴重度增加,這些補償的機制最後會失去它們的功效效力。
更進一步減少功能性的肺容積(functional lung capacity),組織缺氧變得更嚴重且威脅生命,以及通常需要加護照顧的支持,造成COVID-19病人變嚴重的機轉,包括:
1.由於微血管的內皮細胞發炎炎症(endothelial inflammation)和微細小血栓(microthrombi),以及肋膜積水(pleural effusion),造成的增加死腔通氣(increased dead space ventilation)。
2.因為瀰漫性的肺泡發炎(alveolitis)和肺水腫(pulmonary edema),造成氣體擴散的屏障升高(elevated diffuse barrier)。
3.因為肺塌陷(atelectasis),肺實變化和纖維化(consolitation and fibrosis),以及血管新生(angiogenesis),造成由右向左分流增加(increased right-to left shunt)。
總合這些機轉,減少肺泡氣體交換的功能,因此造成嚴重的的動脈低血氧症(hypoxemia)和組織缺氧(hypoxia)。
資料來源:
The COVID-19 puzzle:deciphering pathophysiology and phenotypes of a new disease entity: The Lancet respiratory medicine volume 9,issue 6,P622-642,June 01,2021
感謝學長 #Cheng_Sheng_Tai 醫師 提供資料
同時也有1部Youtube影片,追蹤數超過6萬的網紅Herman Yeung,也在其Youtube影片中提到,人體生理學︰調節與控制 Note download 筆記下載 : https://hermanutube.blogspot.hk/2016/01/youtube-pdf.html -----------------------------------------------------------...
「cardiac output」的推薦目錄:
- 關於cardiac output 在 Facebook 的最讚貼文
- 關於cardiac output 在 劉宗翰中醫小天地 Facebook 的最佳貼文
- 關於cardiac output 在 Soh Wai Ching - Athlete Facebook 的精選貼文
- 關於cardiac output 在 Herman Yeung Youtube 的最佳解答
- 關於cardiac output 在 Cardiac Output (stroke volume, heart rate, preload and afterload) 的評價
- 關於cardiac output 在 Cardiac Output, Stroke volume, EDV, ESV, Ejection Fraction 的評價
cardiac output 在 劉宗翰中醫小天地 Facebook 的最佳貼文
#銀髮樂齡系列2----- 心的保健
首先我們要來談人體"火力"的泉源--- 心臟。
中醫叫做心陽,西醫叫做cardiac output(心輸出),總之這是一個引擎,肩負著推送全身氣血的總源頭。中醫說的"心"這個系統,還不只循環系統的心臟和心血管,還包括大腦神經系統,也算是心的系統所管,所以也叫做"心神"。
上了年紀,是否較常覺得疲累呢?體力耐力漸漸下滑。另外,腸胃的消化機能似乎也比起10年前來得減退,舉例而言,從前去吃all-you-can-eat,還有一些滿足又回本的感覺,現在卻盡量避免這樣吃到飽的餐廳,因為腸胃必須要靠心臟供應足夠的氣血養分,才能正常執行功能,由於心陽漸漸減退,稍微吃得撐了,往往會造成腸胃不舒服好多天。
還有一常見例子,夜間的小便次數變多了,坊間廣告都說腎這個腎那個,其實,是因為心臟開始退化,在白天心臟要"應付"的任務太多,無法替身體排除足夠的水量,於是到入睡之後,全身基本在休養時,心臟才有餘力把血管裡多餘的水分往外排,透過腎臟製造成為尿液。
這些例子從根本上來說,都是心臟的機能在漸漸退化所引起。
也許您會說:我有去心臟科檢查,醫生並沒有說到甚麼問題啊?
是的沒錯,因為這個階段心血管的退化,也許還達不到"疾病"的定義,所以目前就現代醫學而言,也沒有更多的治療方式。不過就中醫而言,從主客觀的症狀,從脈象的變化,就可以推斷心陽減退的情形,能夠做早期的預防,即所謂"養生防病"的概念。
中高齡的朋友們,對於心這個系統的保健,可以分為三個部分,
1 避免勞累,耗損原本已經漸漸減退的心陽,尤其要避免熬夜,熬夜是心臟保健的大忌!
2 透過適度的運動,維持心臟的機能。從最基本的散步開始,運動要讓自己感覺輕鬆,而能持之以恆,效果才能顯著。之前提及的一些導引運動,八段錦等等,都可以斟酌選用。
3 修身養性,培養適度的休閒和文化興趣,多與人群互動,讓情緒和自律神經系統能夠舒緩,"心神"才能舒暢,大腦自然不容易退化。
#延緩心臟退化
#就是最佳的養生鑰匙
cardiac output 在 Soh Wai Ching - Athlete Facebook 的精選貼文
2017 - 2019 NPE Highway Run Challenge Insights (Part 3)
Today I going to share with you all about the important of running your race (10K) at a steady state. Steady state running for a 10k race is usually at around 83 – 88 % of MHR. Well-trained runner will have a higher range for this, and it can be at 92 – 95 % of MHR. How do we identify the steady state during our race?
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We will look at the avg HR and usually it will be at the range of ±6 bpm.
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For example, on how to find out your MHR: (220 – your age, for me is 25 = 195)
3rd KM: 178/195*100 = 91.28% from MHR
9th KM: 183/195*100 = 93.85% from MHR
*For my steady state HR, it’s at 91 – 93.85% (as you can see from 3rd km to 9th km)
*Avg HR might not be a good indicator due to the elevation difference of the course, physiological status of the day and it can be affected by too many factors. Therefore, power output is a better value to look at it.
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The reason of running at steady state is to allow the body turned on the auto-pilot mode. Your breathing rate, gaseous exchange in the alveoli, binding of oxygen to the haemoglobin, blood flow, cardiac output (HR * Stroke Volume), blood pressure, rate of blood flow to the working muscles, diffusion of oxygen to the working muscles, fuel used by the muscles, are in a most efficient and steady state that allows you to keep running at the consistent effort.
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From 3rd km, my body is into the cruising mode and cruise until the 9th km, and I knew I still have the final gear to tap on.
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The advantages of running at steady state are also allow you to be in control, you can press the nitro button to surge, playing psychological tactic during the race.
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*Bonus Tips on how to improve your stride length: Running Drills are the answer. Practicing drills like ankling, high knee, high knee extension, butt kick, heel kick, straight leg, skipping, and the list goes on…
*I am 1.65m, I can still run an avg of 1.48m stride length.
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Hope you guys enjoy the Final Part. There are more to share, till next time 😊
.
#Garmin #GarminMalaysia
cardiac output 在 Herman Yeung Youtube 的最佳解答
人體生理學︰調節與控制
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cardiac output 在 Cardiac Output, Stroke volume, EDV, ESV, Ejection Fraction 的推薦與評價
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cardiac output 在 Cardiac Output (stroke volume, heart rate, preload and afterload) 的推薦與評價
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