医院呼吸机学习.pptVIP

内源性PEEP 概念 intrinsic positive end-expiratory pressure,PEEPi 是指在没有用呼吸机预设PEEP的情况下,肺泡压力在呼气末从而也在整 个呼气 过程保持正压。 临床上产生内源性PEEP的原因 1 气流阻力增加（和呼气流速受限） 2 呼气时间缩短，如反比通气和浅快自主呼吸 3 吸气后呼气肌的兴奋性增高 顺应性（compliance,C） 临床意义 高顺应性提示吸气时低的弹性阻力，同时呼气时低的回缩力 低顺应性提示病人“硬”肺，（如肺纤维化、肺水肿、肺塌陷以及肺挫伤），或胸廓占位性病变如气胸、血胸或伴随腹内压高的肠梗阻 呼气阻力与波形 A 呼气阻力大 呼气流速衰减缓慢，而且在 呼气末流速(Vee)没有回到0 位 B 呼气阻力小 呼气流速衰减快，而且呼气末 流速(Vee)回到0位 呼吸功 work of breathing,WOB 呼吸机做功 WOB v Work of Breathing - ventilator 正常值：0-4J/l 临床意义：呼吸功太小有可能由限制性疾病引起 病人呼吸功 WOB p Work of Breathing - patient 正常值 0.8 J/l * Use as little text as possible (key words instead of body text) The text should always be left justified, never centre or right justified Animations should only be used where appropriate The headline is always to be set in capital letters * Use as little text as possible (key words instead of body text) The text should always be left justified, never centered or right justified Animations should only be used where appropriate The headline is always to be set in capital letters * Use as little text as possible (key words instead of body text) The text should always be left justified, never centered or right justified Animations should only be used where appropriate The headline is always to be set in capital letters * Use as little text as possible (key words instead of body text) The text should always be left justified, never centre or right justified Animations should only be used where appropriate The headline is always to be set in capital letters * Use as little text as possible (key words instead of body text) The text should always be left justified, never centre or right justified Animations should only be used where appropriate The headline is always to be set in capital letters * Use as little text as possible (key words instead of body text) The text should always be left justified, never centered or right justified Animations should only be used where appropriate The headline is alw