呼吸麻醉教学资料 呼吸曲线及环的简件要介绍.pptVIP

呼吸曲线及环的简要介绍 Inadequate Inspiratory Flow Response to Bronchodilator 容量-时间曲线 Pressure/volume loop Pressure/volume loopVentilator work of breathing FCV - PCV Lung Compliance Changes and the P-V Loop Overdistension Air Leak 呼吸功与肺的顺应性C Increased Raw Air Leak AirTrapping Increased Airway Resistance 机控和自控的P/V环变化 * * 波型 流速-时间曲线 压力-时间曲线 容量-时间曲线 图形 压力-容量环 流速-容量环 流速-容量环 容量压力环图 容量时间图 容量压力图 压力时间图 流速压力环图 流速时间图 流速压力环 压力时间图 流速时间图 流速容量环 容量时间图 流速容量环 流速容量环 容量压力环 流速压力环 顺应性 = V/ P 阻抗 = P/ V . 时间常数 = V/ V . Flow (L/min) Time (sec) Normal Abnormal Active Inspiration or Asynchrony Patient’s effort Before Time (sec) Flow (L/min) PEFR After Long TE Higher PEFR Shorter TE Inspiration Expiration Time (sec) Volume (ml) Inspiratory Tidal Volume TI -100 0 100 200 300 400 500 600 Vol [ml] -5 0 5 10 15 20 Paw [cmH2O] -100 0 100 200 300 400 500 600 Vol [ml] -5 0 5 10 15 20 Paw [cmH2O] Vent Patient WOBimp Flow Controlled Ventilation Press. Controlled Ventilation Set values: PIP+PEEP;increases mean airway pressure,improves gas distribution. VT depends on R, C.inconsistent changes in VT with changes in PIP and PEEP. Low internal resistance Spontaneous inspiration is not impaired High,variable inspiratory flows Cycle time or flow 靠监测保正VT(the decelerating flow is thought to improve the distribution of gas flow;when compared to volume control ventilation there is a more rapid improvement in lung compliance and oxygenation) Set values: VT,PEEP. PIP depends on R, C High internal resistance Spontaneous inspiration is impaired due to resistance,volume cycle. Limt inspiratory flows Less atelectasis compared to pressure control The limited flow available may not meet the patient‘s desired inspiratory flow rate.if the patient continues to inspire vigorously .added,unnecessary work is done,this can lead to fatigue.