gasman应用在吸入麻醉教学中的体会-课件.pptVIP

* 罗 艳上海交通大学医学院附属瑞金医院 Gas Man 应用在 吸入麻醉教学中的体会 Exercises Wash-in of a single compartment Wash-in of a single compartment produces an exponential curve Wash-in of a single compartment τ =t 0.63 τ equals the time required for the curve to reach 1-e-1, or 63% of its final value At the end of 1,2,3,4,5 time constants, the circuit tension equals 63%,87%,95%and 99% of the delivered from the vaporizer Wash-in of a single compartment τ = V/F The time constants for wash-in of a single compartment equals effective volume divided by effective inflow rate Wash-in of a single compartment τ = V/F Circuit volume is 8 liters τ = V/F = 8/4 =2min Inspired tension reached 63% of delivered Two Sequential Compartments Breathing circuit patient’s lungs Lung’s τ = FRC/VA FRC: functional residual capacity VA: alveolar ventilation Two Sequential Compartments Lung’s τ = FRC/VA FRC: functional residual capacity VA: alveolar ventilation Alveolar tension curve (ALV) looks identical to the inspired tension curve(CKT) Two Sequential Compartments Overpressure can speed the rise in anesthetic tension tow compartments away Objective: achieve 70% alveolar tension smoothly and quickly Alveolar Tension Curve Open circuit alveolar tension curve is the alveolar response to a step change in inspired tension, representing patient wash-in Alveolar Tension Curve Alveolar Tension Curve Initial rise in the alveolar tension curve is results from alveolar wash-in responsive to a step change in inspired tension Alveolar Tension Curve Alveolar Tension Curve Lower ventilation slows initial rise in alveolar tension Alveolar Tension Curve VA ：7.5 ---- 1.25 τ ：0.33 ----- 2 Alveolar tension reach a final value equal to inspired tension under the condition of CO=0 Alveolar Tension Curve Uptake produces a knee and plateau in alveolar tension Disable return : empty venous anesthetic tension bar (VEN) 3min pause Alveolar Tension Curve Increasing alveolar ventilation rai