呼吸治疗最佳湿化.pptVIP

日常护理 口腔 护理 饮食慢 防误吸 活动 不要 牵拉 鼻导管 患者的护理 患者还有那些疑难问题有待更换的解决呢？ PT怎么减低？ 便秘怎么治疗？ 患者依赖性太强，就是不肯出院？是好还是不好？ 我们科室有预防深静脉血栓的仪器能用吗？ * Slide 11 - 气体调节和湿，热回收 前面已就粘液纤毛转运系统作了回顾，现在就让我们在细胞水平上看看气体调节以及湿，热回收的情况。 吸气阶段- 气体调节 如果吸入的空气温度低于深层体温，那么当较凉的空气经过并广泛暴露在鼻，口咽表面时，热量就会从粘液，溶胶层以及下面的组织里获取。随着这些空气变热，它们容纳水蒸气的能力就会增加，这样水分就会从粘液，溶胶层里蒸发出来直至空气被饱和为止。 这个加温和蒸发水分的过程将使粘膜变凉。粘膜需由系统储备补充水分和热量 (例如： 细胞液和细胞间液的血液供应)。但是补充的速度是有限制的，如从气道提取太多热量和水分的话气道就会出现问题。 呼气阶段- 热量和水分的回收 从粘膜表面丧失的热量和水分会使粘膜变凉变干。当温暖湿润的气体从下部气道呼出来时会与较冷的粘膜表面接触并形成冷凝(就象温暖的浴室空气在较冷的浴室镜子上形成冷凝一样)。这样有一部分原来在吸气时被加上的水分和热量会重新回到粘膜里以准备下一次吸气。可是，在呼气最终阶段仍然有一定的热量和水分缺口必须由系统储备补充。 * * Nasal High Flow Overview As an overview, Nasal High Flow allows you to comfortably and effectively deliver high flows of blended oxygen to your hypoxemic patients. with mild to moderate respiratory distress. What makes Nasal High Flow possible is the introduction of Optimal Humidity, which is considered to be 37°C and 44 mg/L. This level of humidity enables you to deliver high flows of an oxygen blend comfortably through the wide bore Optiflow? nasal cannula. The delivery of high flows provides four key benefits to your patients: You can accurately deliver up to 100% oxygen, washout the anatomical dead space of the upper airway, deliver low levels of positive airway pressure throughout the entire respiratory cycle, and while maintaining the mucociliary clearance mechanism of the mucosa. We will now go into each of these points in more detail. * Where does NHF Fit in the Care Continuum? If we look at the respiratory care continuum, what you can see is that Nasal High Flow fits in between Noninvasive Ventilation and Face Mask Oxygen Therapy. In fact, Face Mask oxygen therapy may no longer be necessary due to the ability for Nasal High flow to deliver high flows using a nasal cannula. The reason NHF fits in between these two therapies is a direct result of the benefits the therapy provides which we will be discussing shortly. * Optimal Humidity It is through the delivery of optimal humidific