呼吸机波形及其临床意义精品文档.ppt

1 2 3 4 5 6 SEC 1 2 3 4 5 6 P a w cmH 2 0 60 -20 120 120 SEC V . LPM 异常波形纠正 How do you know that the problem is with the patient? 120 1 2 3 4 5 6 SEC 1 2 3 4 5 6 P aw cmH 2 0 60 -20 120 SEC V . LPM No flow as pressure rises 异常波形纠正 How do you know that the problem is with the patient? 这种情况时压力支持可以选择 P T Patient allowed to breath spontaneously during inspiratory time in PCV 主动呼气阀 P Time V . Time Any ideas whats represented here? What is this? What is this? FAP = 1 FAP = 50 FAP = 100 流速加速率 压力释放 压力过冲 FAP = 1 FAP = 50 FAP = 100 流速加速率 压力通气 ? 恒定的压力 . ? 递减 , 可变的流量 ? 时间切换 : (A) ? Pressure Control ? 流速切换 : (B) ? Pressure Support Pressure Flow A B Time Cycled Flow Cycled 压力通气波形 Flow Pressure Tinsp. PIP Peak Flow 25% Pressure Control Pressure Support 1 2 3 4 5 6 60 P a w cmH 2 0 Sec What is this? 1 2 3 4 5 6 60 P a w cmH 2 0 Sec 压力过冲伴反冲 压力 - 时间曲线的临床意义 ? 区别各种通气模式和特殊通气方式 ? 估计触发的做功 ? 计算吸 - 呼时比，估计呼气时间是否充足。 ? 估计是否达到充分的平台压 ? 观察压力上升速度估计所用吸气流速是否 适合 ? 测定静态呼吸力学参数 ? 显示压力波型形态 1 2 3 4 5 6 30 -10 P a w cmH 2 0 Sec 病人呼吸机同步 1 2 3 4 5 6 30 -10 P a w cmH 2 0 Sec Adequate Flow 病人呼吸机同步 V olume ventilation delivering a preset flow and volume 1 2 3 4 5 6 30 -10 P a w cmH 2 0 Sec Air Starvation What options do we have? 病人呼吸机同步 The patient is outbreathing the set flow 控制通气 Volume Ventilation Pressure Ventilation Pressure Flow time Pressure Flow time Assist/Control SIMV + Pressure Support Pressure supported spontaneous + Patient, or machine- initiated mandatory breaths Paw CPAP Synchronized IMV A/C 5 bpm SIMV 5 bpm 12 sec Assist Window SIMV vs. Assist/Control Pressure Time 如何影响 MAP