机械通气新模式及其证据.pptVIP

The Newer Ventilation Modes and Their Evidence Base 机械通气新模式及其证据 邵逸夫医院危重医学科 The Newer Ventilation Modes Dual-Control Modes Auto Mode Airway Pressure-Release Ventilation(APRV) Proportional-assist ventilation (PAV) Adaptive support ventilation (ASV) Automatic tube compensation (ATC) Dual-Control Modes 双重控制模式 Dual-Control Modes Dual-Control Within-a-Breath Dual-Control Breath-to-Breath Dual-Control Within-a-Breath Volume-Assured Pressure Support (VAPS) Bird 8400STi Pressure Augmentation Bear 1000 Dual-Control Within-a-Breath 触发后以PSV（按需流速）送气，至预设压力水平 当流速降至预置恒流值前， 如VTVTset ---PSV 当流速降至预置恒流值前， 如VTVTset，保持恒流至VTset 需设置恰当的压力和恒流值 保证VT，降低通气负荷，改善人机协调 Dual-Control Within-a-Breath Dual-Control Within-a-Breath Dual-Control Breath-to-Breath Dual-Control Breath-to-Breath, Pressure-Limited, Time-Cycled Ventilation (PCV) Dual-Control Breath-to-Breath, Pressure-Limited, Flow-Cycled Ventilation (PSV) Dual-Control Breath-to-Breath, Pressure-Limited, Time-Cycled Ventilation (PCV) Pressure-Regulated Volume Control PRVC (Siemens 300) Autoflow (Drager Evita 4) Adaptive pressure ventilation (Galileo) volume-control+ (PB 840) Dual-Control Breath-to-Breath, Pressure-Limited, Time-Cycled Ventilation (PCV) 根据P-V曲线，计算VTset所需压力，按75％送气，通过连续调整，至VTset。 压力在PEEP ～Plimit之间自动调整，每次≤3cmH2O 按需递减流速， VT恒定，降低Paw，人机协调 Dual-Control Breath-to-Breath, Pressure-Limited, Time-Cycled Ventilation (PCV) 与容量控制模式相比，潮气量是波动的，然而相对稳定，但气道压力较容量控制者为低。 与压力控制模式相比，压力有所波动，但潮气量基本稳定。 Dual-Control Breath-to-Breath, Pressure-Limited, Time-Cycled Ventilation (PCV) Dual-Control Breath-to-Breath, Pressure-Limited, Time-Cycled Ventilation (PCV) Dual-Control Breath-to-Breath, Pressure-Limited,Time-Cycled Dual-Control Breath-to-Breath, Pressure-Limited, Flow-Cycled Ventilation (PSV) Volume Support Ventilation VSV (Siemens 300) Variable Pressure Support (Venturi) Dual-Control Breath-to-Breath, Pressure-Limited, Flow-Cycled Ventilation (PSV) 基本通气模