械通气总论-nursing.ppt

肺或胸廓限制性疾病 减少死腔通气的方法 降低分钟通气量 纠正低血容量 * * * * * * * * * * * * * * * The cause of the high airway pressure may also be obstruction in the ventilatory circuit. This is most commonly due to water pooling in the circuit or to a filter that is filled with water. Note that the obstruction is often in the expiratory limb of the circuit which results increased PEEP and hence airway pressure[paw12] * * * * * * * * * * * * If a patient desaturates while on a mechanical ventilator it is important to consider both patient causes and equipment causes. Increase the inspired oxygen concentration to 100% and quickly check that the patient’s chest is still moving before going on to a more detailed examination. * If the chest is not moving it may be a problem with the ventilator but this is unusual. In this situation the patient will be easy to ventilate manually. If the chest is not moving and the patient is not easy to ventilate then the problem is similar to a high airway pressure problem. * More commonly the chest is still moving. A detailed examination of the chest should be carried out looking in particular for endobronchial intubation, pneumothorax, collapse, pulmonary oedema and bronchospasm. In addition patient ventilator dysynchrony may result in desaturation. * If a patient desaturates while on a mechanical ventilator it is important to consider both patient causes and equipment causes. Increase the inspired oxygen concentration to 100% and quickly check that the patient’s chest is still moving before going on to a more detailed examination. If the chest is not moving it may be a problem with the ventilator but this is unusual. In this situation the patient will be easy to ventilate manually. If the chest is not moving and the patient is not easy to ventilate then the problem is similar to a high airway pressure problem. More commonly the chest is still moving. A detailed examination of the chest should be carried out looking in particular for endobronchial intubation, pneu