呼吸机波形分析21730.pptxVIP

呼吸机波形分析Ventilator Waveform Analysis 唐殿成学习流程1. Know Your Normal First:/idsweb/tech_reviews/Ghazi/page01.htmlTime-based waveforms in Volume and Pressure-targeted ventilation/idsweb/tech_reviews/Ghazi/page02.htmlVolume-Pressure and Flow-Volume Loops 2. Abnormal Time-Based Waveforms:/idsweb/tech_reviews/Ghazi/abn_FT.htmlFlow-Time Curve/idsweb/tech_reviews/Ghazi/abn_VT.htmlVolume-Time Curve/idsweb/tech_reviews/Ghazi/abn_PT.htmlPressure-Time Curve 3. Abnormal Loops:/idsweb/tech_reviews/Ghazi/abn_PV.htmlPressure-Volume Loop/idsweb/tech_reviews/Ghazi/abn_FV.htmlFlow-Volume LoopNormal Time-based Curves（1）容量控制通气1、Pressure-Time,2、Flow-Time3、Volume-Time CurvesNormal Time-based Curves（2）压力控制通气1、Pressure-Time,2、Flow-Time3、Volume-Time Curves原理流速—时间曲线反映了吸气相和呼气相各自的流速变化，流速的单位为升/分（纵轴），而时间单位为秒（横轴），横轴上的曲线为吸气流速，横轴下的曲线为呼气流速，呼吸机输送的容量是流速在时间上积分计算而得且等于流速曲线下面积。 23流速LPM吸气相时间1呼气相图1 流速曲线（方波）--机械呼吸 45Flow versus TimeSQUAREDECELERATINGACCELERATINGSINE原理容量—时间曲线中，上升肢代表了容量输送到病人，下降肢代表了总的呼出潮气量。典型的呼出容量等于吸入容量，除非存在着漏气。呼时间吸时间ABVTLITERSTIMEInspiratory Tidal VolumeVolume vs TimeVolume (ml)InspirationExpirationTITime (sec)压力-时间曲线的原理 A至B点的压力明显增加是由于从呼吸机至肺整个系统的阻力所致，此压力即为克服阻力的压力。 C点为峰压代表充气压力，对抗气流的压力和肺扩张的压力。 D至E点平台压力，需要扩张肺泡的压力。平台期无气体供应到肺，吸气流速是零。 E点呼气开始。F点呼气结束，压力再次回复到呼气末水平 Peak Inspiratory PressurePIPPEEP Pressure versus TimePaw (cm H2O)InspirationExpirationTITE}Time (sec)Normal /idsweb/tech_reviews/Ghazi/page02.htmlVolume-Pressure and Flow-Volume Loops Pressure-Volume LoopEEVol (ml)IEIIPaw (cm H2O)SpontaneousControlledAssistedI: InspirationE: ExpirationAbnormal Time-Based Waveforms 1、/idsweb/tech_reviews/Ghazi/abn_FT.htmlFlow-Time Curve 2、/idsweb/tech_reviews/Ghazi/abn_VT.htmlVolume-Time Curve 3、/idsweb/tech_reviews/Ghazi/abn_PT.htmlPressure-Time CurveAbnormal Loops 1、/idsweb/tech_reviews/Ghazi/abn_PV.htmlPressure-Volume Loop 2、/idsweb/tech_reviews/Ghazi/abn_FV.htmlFlow-Volume LoopAbnormal Flow-Time Curve（1）1、Airway Obstruction ——气道阻塞 表现：呼气峰流速降低、呼气时间延长 常见原因：气道阻力增加（气管内黏液增加或分泌物聚集）Abnormal Flow-Time Curve（2）2、Air tr