呼吸机的智能化发展.pptVIP

5.由病人自主呼吸驱动的新型感受器驱动模式 (一)比例辅助通气 PAV(Proportional Assist Ventilation) 吸气努力程度与潮气量的关系 工 作 原 理 正 常 呼 吸 时 ， 呼 吸 肌 收 缩 产 生 一 定 的 压 力 ，它 是 吸 气 的动 力 。 气 流 的 阻 力 包 括 气 道 的黏性 阻力 、弹 性 阻 力 和 惯 性 阻 力 。 由吸气 流速产 生 ，代 表 呼 吸 系 统压 力 与 流 速 的关 系 ， 由肺 容 积产 生 。  机 械 通 气 时 ， 呼 吸 过 程 中 呼 吸 系 统 上 的 压 力 由 吸气 肌 收缩 产 生压力 共同产生。 其中K1是Paw与吸气容量间的比例，K2是Paw与流速间的比例。 示意图 肺 呼吸肌 气道阻力 顺应性 Model Prm Pres V Prm Pres Pel 气道阻力 (kPas/l) 顺应性 C (ml/mbar) 弹性阻力 E ( mbar/ml) 压力 (mbar) V 流速 F(l/min) ~ (pneumatical symbols) (electrical symbols) NAVA Training Presentation 2007 NAVA Training Presentation.ppt * NAVA Training Presentation 2007 NAVA Training Presentation.ppt * NAVA will provide respiratory assistance in full synchrony with the respiratory effort made by the patient (respiratory rate, duration of the breath and the tidal volume).The neural respiratory rate may be modified by the NAVA level. But synchrony will still be maintained. NAVA Training Presentation 2007 NAVA Training Presentation.ppt * The electrical discharge of the diaphragm is captured through the introduction of an Edi Catheter fitted with an electrode array. Since NAVA uses the Edi to control the ventilator, it is important to understand what the signal represents. All muscles (including the diaphragm and other respiratory muscles) generate electrical activity to excite muscle contraction. This electrical excitation is controlled by nerve stimulus and controlled in magnitude by adjusting the stimulation frequency (rate coding) or by adjusting the numbers of nerves that are sending the stimulus (nerve fiber recruitment). Both, the rate coding and nerve fiber recruitment will be transmitted into muscle fiber motor unit action potentials which will be summed both in time and space producing the intensity of the electrical activity measured on the muscle. To reduce the influence of external noise, the measurement of the muscle electrical activity is performed by bipo