机械通气的模式seminar2008精品.ppt

* * * * * * * Well, fortunately, they do. Two studies give us these results regarding operator and ventilator activity during ventilation with ASV: [Click: Next slide.] * Patient comfort. This study of ten patients measured patient comfort, as indicated by two criteria. The graph on the left shows comfort measured by the P/zero/one criterion. That is, the pressure in the airway at 0.1 seconds after inspiration begins. ASV is compared with SIMV-PS. There are two SIMV-PS measurements. SIMV-PS Measurement 1 (the column of dots on the left) give an average value of 1.8 centimeters of water. SIMV-PS Measurement 2 (the column of dots on the right) give an average value of 1.6 centimeters of water. However, the ASV measurement gives an average of only 1.1 centimeters of water. This is a very strong indication that ASV causes much lower levels of stress to patients than does traditional SIMV-PS ventilation. Let’s look at the second graph. This shows the electro-miographic index for the sterno-cleido-mastoid muscle in the neck. This is another criterion of patient comfort. SIMV-PS Measurement 1 for each patient is defined as having a value of 100. (This is an arbitrary scale. There are no defined units as such.) SIMV-PS Measurement 2 for each patient (the column of dots on the right) spreads out above and below the base value of 100. However, the ASV measurement is consistently below the 100 base value, with an average reading of only 34. [Click: Next slide.] * * The Edi Catheter is positioned too far up – the bottom leads are highlighted in blue. Insert the Edi Catheter in steps corresponding to the IED distance until the blue highlight appears in the centre. Note:Do not insert more than 4 times the IED distance. * Traditional ventilator treatment implies that the brain and the ventilator work like two oscillators, the brain generating breaths dependant upon neural and chemical input – The ventilator in its turn is expecting a mechanical input from the airways before