机械通气适应症（Mechanical ventilation indication）.docVIP

机械通气适应症（Mechanical ventilation indication） Indications, contraindications and complications of mechanical ventilation (I) indications 1 clinical manifestations of respiratory failure such as dyspnea, cyanosis, cough, unable to stop or unconsciousness, circulatory dysfunction etc. 2 respiratory physiological criteria for mechanical ventilation 1) respiratory rate R35/ minutes 2) lung capacity, VC10-15ml/kg weight (3) the partial pressure difference of Alveolar arterial blood pressure was P (A-a) O250mmHg (6.65Kpa, Fi, O2=0.21) 4) maximum inspiratory pressure PNP25cmH2O (2.45KPa) (5) arterial carbon dioxide partial pressure PaCO250mmHg (6.65Kpa) except COPD patients 6) physiological void / tidal volume 60% 3 selection of indications for mechanical ventilation under different underlying diseases 1) COPD patients with chronic respiratory failure due to acute deterioration of rational oxygen therapy, the pH value of 7.2PaO2 is still 45mmHg, PaCO275mmHg 200ml; tidal volume, respiratory rate 35 / min; early cerebral change 2) bronchial asthma status after routine treatment, the following circumstances: respiratory depression, delirium appears; respiratory muscle fatigue; PaO2 decreased below 50 mmHg, PaCO2 increased more than 50 mmHg; the general state deteriorated 3) ARDS after several hours of high concentration (60%) oxygen treatment, PaO2 is still lower than 60 mmHg or PaO2 at 60 mmHg or more, but it is associated with respiratory acidosis 4) respiratory failure caused by head trauma and neuromuscular disorders 5) respiratory failure caused by excessive inhibition of respiratory centers due to excessive sedation. After oxygen improvement is not ideal, or respiratory frequency 30-40 / minute reflex, unable to cough expectoration. 6) myocardial infarction or congestive heart failure combined with respiratory failure, oxygen concentration has reached more than 60%, PaO2 is still less than 60 mmHg, careful mechanical ventilation (should use pressure support mode). 7) mecha