(精选)ARDS患者PEEP滴定调节教学课件.pptVIP

Department of the Intensive Care Unit, the No.4 Hospital Affiliated to Kunming Medical University Xiu Guang-hui;What is Acute Respiratory Distress Syndrome (ARDS)?;;Intact Alveolus;Reconstitution of Epithelium Removal of Provisional Matrix Apoptosis of Fibroblasts Limiting Myofibroblast Differentiating ;Chest X-ray:;Chest CT Scan: Bilateral Infiltrates Are Heterogeneous;Evolution of Pathogenesis:;Stepwise Incremental vs.Decremental PEEP titration;Stepwise PEEP according to oxygenation– Titrate PEEP to achieve target oxygenation (55 mmHg ≤ PaO2 ≥ 80 mm Hg or 88% ≤ SpO2 ≥ 95%)，then reduce FiO2– Using target scale of FiO2/ PEEP from NIH ARDS Network study 2000;Setting PEEP at 2 cm H2O above lower inflection point in static pressure volume curve;;defined as optimal PEEP;Conclusions;;;A global inhomogeneity (GI) index based on EIT wasrecently developed to quantify the tidal volume distribution within the lung。 where DI denotes the value of the differential impedance in the tidal images; DIxy is the pixel in the identifiedlung area; DIlung are all pixels in the lung area underobservation;;Thank you for your attention