What is pulmonary encephalopathy and what does it look like?

Pulmonary encephalopathy is chronic bronchitis complicated by emphysema, cor pulmonale and pulmonary failure caused by brain tissue damage and cerebral circulatory disorders. The main manifestations are headache, dizziness, memory loss, and lack of energy.

The main cause of pulmonary encephalopathy in the elderly is chronic cor pulmonale, and the common causes are acute respiratory and pulmonary infections, severe bronchospasm, and sputum obstruction in the airways further reduces the already impaired pulmonary ventilation function.

a.Alveolar hypoventilation leads to brain dysfunction.

b.Dysfunction of cerebral function due to hypoventilation of the lungs.

c.Brain dysfunction due to respiratory failure.

d.Brain dysfunction caused by "CO2 anesthesia" is ruined.

e.Brain dysfunction due to hypoxia.

Correct Answer: Brain dysfunction due to respiratory failure.

1. Pulmonary encephalopathy is a symptom of insufficient oxygen supply caused by respiratory failure.

It is generally manifested as apathy, drowsiness, coma, etc.

Abnormal changes due to ischemia and hypoxia may occur within the skull.

2. When he wakes up, he may be holding his breath and waking up, so he will have a sense of impending death, so he will resist desperately, and his strength will be great.

3. Protein infusion is ineffective, because it is not caused by hypoproteinemia, oxygen inhalation should be effective, and it is better if it can be supported by a ventilator.

1.Blood gas analysis showed an increase in PAC2, an increase in carbon dioxide binding, an increase in the content of standard bicarbonate and residual alkali, and a decrease in blood pH.

2.Increased cerebrospinal fluid pressure, increased red blood cells, etc.

3.Electroencephalogram (EEG) shows diffuse chronic wave abnormalities of varying degrees and may have paroxysmal changes.

Mainly based on chronic lung disease with pulmonary failure; Clinical manifestations include impaired consciousness, neurological, psychiatric symptoms, and localized neurological signs; Pulmonary insufficiency and hypercapnia on blood gas analysis; Diagnosis is made after excluding neurological and psychiatric disorders caused by other causes.

1. Hepatic encephalopathy: It is a syndrome of central nervous system dysfunction caused by severe liver disease and based on metabolic disorders, and the main clinical manifestations are consciousness disorders, behavioral disorders and coma. Portosystemic shunt encephalopathy, emphasizing portal hypertension, and the existence of collateral circulation between the portal vein and the vena cava, so that a large amount of portal venous blood bypasses the liver and flows into the systemic circulation, which is the main mechanism of encephalopathy.

Pulmonary encephalopathy: also known as emphysema encephalopathy, carbon dioxide anesthesia or hypercapnia, is a clinical syndrome of various neuropsychiatric symptoms caused by various chronic pulmonary thoracic diseases with respiratory failure, leading to hypoxemia and hypercapnia. 2. The main diagnostic basis for the clinical manifestations of hepatic encephalopathy is:

Severe liver disease (or) extensive portosystemic collateral circulation; mental disorder, lethargy or coma; precipitating hepatic encephalopathy; Significant hepatic impairment or increased blood ammonia. Asterixis tremor and typical EEG changes are of important reference. Digital connectivity tests and mental intelligence tests in patients with cirrhosis can detect mild hepatic encephalopathy.

The clinical manifestations of pulmonary encephalopathy are mainly diagnosed based on: on the basis of confirmed pulmonary insufficiency caused by chronic lung diseases and respiratory disorders; If inhibition and haze, lethargy, agitation, coma are found; Pulmonary encephalopathy should be diagnosed when arterial blood gases, partial pressure of CO2, and CO2 binding are suggestive of decreased oxygen and pH. 3. Hepatic encephalopathy is caused by various types of liver cirrhosis (viral hepatitis cirrhosis is the most common) and portosystemic shunt, including such as transjugular intrahepatic portosystemic shunt (TIPS), if even mild hepatic encephalopathy is counted, the incidence of hepatic encephalopathy in liver cirrhosis can reach 70%.

A small proportion of hepatic encephalopathy occurs in the acute or fulminant stages of liver failure in severe viral hepatitis, toxic hepatitis, and drug-induced liver disease. The rest are seen in primary liver cancer, acute fatty liver during pregnancy, severe biliary tract infection, etc. Pulmonary encephalopathy is caused by CO2 poisoning, or CO2 anesthesia, respiratory acidosis, and hypoxia.

Brain dysfunction caused by respiratory failure is called pulmonary encephalopathy. Its main pathogenesis: carbon dioxide directly dilates cerebral blood vessels, and hypoxia can also dilate cerebral blood vessels, thus causing cerebral congestion.

Hypoxia and acidosis damage the endothelium of the blood vessels, increasing its permeability, resulting in interstitial edema. Hypoxia reduces the production of ATP in brain cells, affects the function of Na+ pump, causes an increase in intracellular Na+ water, and forms edema of brain cells. Cerebral congestion and edema caused by the above factors increase intracranial pressure, compress cerebral blood vessels, and make cerebral hypoxia more serious, forming a vicious circle, which can lead to the formation of cerebral herniation in severe cases.

The decrease in cerebrospinal fluid pH is more pronounced than that of blood during exhalation, leading to intraneuronal acidosis, which can enhance cerebral glutamate decarboxylase activity, increase R-aminobutyric acid production, and lead to central inhibition. In addition, it can enhance phospholipase activity, causing lysosomes to release hydrolase enzymes, causing damage to nerve cells and tissues.