呼吸机波形解读.pptxVIP

PV tool and lung recruitment;;Prevention of VILI;What do we know about ARDS?;Effect of PEEP on mortality in ARDS;Effect of PEEP on mortality in ARDS;What do we know about PEEP?;;Am J Respir Crit Care Med 2006;24 sur 26 patients;n = 68;Recruitability depends on;Type of ARDS;Time from the beginning of the disease;24 on 26 patients;Chest wall compliance;Chest wall complianceAirway pressure is a rough estimate of transpulmonary pressure;Assessment of recruitability;Assessment of recruitability;Assessment of recruitabilityShape of the curve;Assessment of recruitabilityLinear compliance;;Assessment of recruitabilityHysteresis;;Assessment of recruitabilityHysteresis and volume difference at 20 cmH2O;Assessment of recruitability;Assessment of recruitability;Clinical case;Clinical case;Decision at the bedside;Decision at the bedside;Definition of a recruitment maneuver;Justification and goal for RM;Method for RM;Volume recruited depends on;Pressure and time;Time;Optimal duration of the recruitment maneuver;Optimal duration of the recruitment maneuver;Sustained inflation recruitment maneuver;;;;Clinical case;Recruitment maneuver at the bedsideConditions;Recruitment maneuver at the bedsideContraindications;Recruitment maneuver at the bedsideSettings;How to set PEEP after recruitment maneuver?;Setting PEEP according to inflation PV curve ;Hickling. AJRCCM 2001;PEEP setting guided by esophageal pressure;PEEP setting guided by esophageal pressure;PEEP setting guided by esophageal pressure;PEEP setting guided by esophageal pressure;PEEP setting guided by esophageal pressure;PEEP setting guided by esophageal pressure;PEEP setting guided by esophageal pressure;Clinical case;Clinical case;;;Conclusions