高流量氧疗的生理效应,俞康龙教学教材.pptVIP

高流量氧疗的生理效应,俞康龙 COI statement The author has no conflict of?interest to declare. High Flow an interesting oxygenation method - novel - magic - gentle and moderate HFNC shines during RSI Put the big cannulae into your patient’s nose and let’r rip. Add a face mask or NIV or whatever your preoxygenation pleasure, then push your meds and laugh to yourself as the saturation rises during apnea. Whistle sweetly as the intern illuminates every inch of the soft palate with great determination. Hell, go see another patient and tell him to call you when he’s given up. You remember, though, the days of the giants. When being regarded as a skilled laryngoscopist meant something. When the word?airway?made internists scatter like mice. When it wasn’t so easy to save a life. /2012/03/01/the-high-flow-nasal-cannula-in-the-emergency-department/ Pediatrician has promoted oxygen therapy 1891-- E. Bonnaire described O2 inhalations in the newborn Oxygen therapy oxygen delivery devices Oxygen Therapy Low flow systems High flow systems Nasal cannula Face tent O2 tent Venturi mask PRBM NRBM NIV (CPAP) ET tube Simple mask HFNC The role of HFNC in respiratory therapy What is HFNC? a “new” methods of oxygen therapy air/oxygen applied to patient at high flow rates air/oxygen run through a nasal cannula air/oxygen is well conditioned by sufficient warmth and humidification --so called heated, humidified high-flow nasal cannula (HHHFNC) therapy 2-70 L/min Mechanisms of action for HFNC Washout of nasopharyngeal dead space Reduction of inspiratory resistance (work of breathing) by providing adequate flow Improved mechanics by supplying adequately warmed and humidified gas Reduction in the metabolic cost of gas conditioning Provision of distending pressure Washout of nasopharyngeal dead space The high volumetric flows pouring from a small bore cannula cause high velocity flows which create turbulent energy to flush the upper airway of expiratory gas. Dead space washout improves v