新生儿呼吸机模式和呼吸机管理.ppt

呼吸支持治疗指引GDWCH 2016 否 是 Thank You!!! 欢迎随时联系德国海伦 周金松微信号邮箱 呼吸机构造：1、动力:空气、氧气气源，2、呼吸机主机，3、呼吸管路，4、湿化器 . * CPAP呼吸机通过一定的吸气压力，在吸气相产生持续的正压气流；呼相时，呼气系统活瓣对呼出的气也给予一定的阻力，以使得吸呼相均高于大气压。 主要作用：在病人有自主呼吸时才可以用，一般做一些病人肺功能的测定，或者改善COPD肺患者通气。 * * 发生器由丹麦 邦尼卫斯特 发明 * CPAP呼吸机通过一定的吸气压力，在吸气相产生持续的正压气流；呼相时，呼气系统活瓣对呼出的气也给予一定的阻力，以使得吸呼相均高于大气压。 主要作用：在病人有自主呼吸时才可以用，一般做一些病人肺功能的测定，或者改善COPD肺患者通气。 * * * * 23 23 11 11 11 11 24 20 Background: Why C20/C: Mechanical ventilation should provide adequate minute ventilation with the least risk of barotrauma. Barotrauma or volutrauma is a common complication of neonatal mechanical ventilation. Many factors are involved in producing lung damage, including excessive gas flows, inadvertant PEEP, and high Pinsp. The terminal portion of the p-v loop of a mechanical breath appears to be a marker of lung distention near maximum tidal volume. How to interprete single values for lung compliance? Single value for lung compliance allows overall information of volume changes per unit pressure but it is not possible to distinguish whether the volume changes are outside the linear portion of the P-V curve. During spontaneous breathing, inspiration begins usually at a stable volume and proceeds to a point within the range of normal tidal volume (Linear portion of the p-v curve. During mechanical ventilation of a diseased lung it may be different. FRC may be normal, reduced, or increased, depending upon the volume history of the lung and the underlying disease state. Thus, lung compliance will vary, depending on the condition of the lung, its volume history (amount of FRC) and the variations of pressure and volume changes. The inspection of the C20/C ratio ( evtl. together with inspection of P-V loop) during mechanical ventilation allows rapid identification of volume changes outside the linear portion of the lung curve and hence lung overdistension may be identified before lung rupture occurs. notes: _______________________________________