机械通气临床应用(创伤)【呼吸治疗科】.ppt

Flow vs Time ACCELERATING DECELERATING SINE SQUARE * ppt课件 Volume vs Time Inspiration Expiration Time (sec) Volume (ml) Inspiratory Tidal Volume TI * ppt课件 Pressure vs Time Inspiration Expiration Paw (cm H2O) Time (sec) } TI Peak Inspiratory Pressure PIP PEEP TE * ppt课件 Pressure-Volume Loop Controlled Assisted Spontaneous Vol (ml) Paw (cm H2O) I: Inspiration E: Expiration I E E E I I * ppt课件 Flow-Volume Loop Volume (ml) PEFR FRC Inspiration Expiration Flow (L/min) PIFR VT * ppt课件 气体陷闭 Inspiration Expiration Normal Patient Time (sec) Flow (L/min) Air Trapping Auto-PEEP } * ppt课件 气体陷闭 Inspiration Expiration Volume (ml) Flow (L/min) Does not return to baseline Normal Abnormal * ppt课件 Paw (cm H2O) Normal Normal PPlat (Normal Compliance) Increased PIP } Increased PTA (increased Airway Resistance) Normal PIP PPlat High Raw PIP PPlat Increased Airway Resistance * ppt课件 支扩剂治疗反应 Before Time (sec) Flow (L/min) PEFR After Long TE Higher PEFR Shorter TE * ppt课件 Raw 增高 Pressure (cm H2O) Higher PTA Normal Slope Vol (mL) Lower Slope * ppt课件 Raw 增高 Inspiration Expiration Volume (ml) Flow (L/min) Decreased PEFR Normal Abnormal “Scooped out” pattern * ppt课件 呼吸功 A: Resistive Work B: Elastic Work Pressure (cm H2O) Volume (ml) B A * ppt课件 肺过渡膨胀 Volume (ml) Pressure (cm H2O) With little or no change in VT Paw rises Normal Abnormal * ppt课件 Peak Flow 不足 Adequate Flow Time (sec) Inadequate Flow Paw (cm H2O) * ppt课件 Peak Flow 不足 Flow (L/min) Time (sec) Normal Abnormal Active Inspiration or Asynchrony Patient’s effort * ppt课件 Peak Flow 不足 Paw (cm H2O) Volume (ml) Normal Abnormal Active Inspiration Inappropriate Flow * ppt课件 Synchronized intermittent mandantory venilation (SIMV) 同步间歇强迫式呼吸，简称 SIMV。 类似 A/C + Spontaneous breathing 。准许病人在两次机器给气间自行呼吸。 适用于 吸气驱动能力正常，呼吸肌肉仍未很有力气者。 希望减少机器辅助次数，增加病人自行呼吸的　次数(如:计画协助病人脱离呼吸时)。 可避免因使用A/C mode 造成之过度通气或与呼 吸器抵抗的现象。 * ppt课件 Pressure ventilation PSIMV 控制呼吸 与自主呼吸 triger 同步 (A/C mode + Spontaneous breathing)  Volume ventila