呼吸机与危重症PPT课件.ppt

Because the lung tissue is made up of elastic and collagen fibers, the lungs possess a property called elastance. In physics, elastance is defined as the tendency of a structure to offer resistance to a stretching force. In terms of ventilation, elastance is the tendency of the lungs to resist inflation. A certain amount of pressure is required to stretch the lungs to a certain volume. A normal value for elastance is about 10 cmH2O/L. In disease, the lungs may become stiffer; the same pressure change may result in a smaller volume change. The elastance of the lungs is higher. What types of lung diseases would alter the elastance of the lungs? Pneumonia, pulmonary edema and ARDS are common conditions affecting elastance. Speaker note: Other responses may include fibrotic lung disease, pneumothorax, pleural effusion, kyphoscoliosis, obesity. Compliance is another term used to describe the lungs opposition to inflation. Compliance measures the distensibility of the lungs or ease with which the lungs inflate. Mathematically, compliance is the inverse (reciprocal) of elastance. For purposes of our discussions on PAV, we will always talk about elastance. * The second opposing force that is encountered in ventilation are the frictional forces. Impedance to air movement through the airways is called airways resistance. Resistance is defined as the ratio of the pressure change responsible for air movement and the rate of air flow. A normal value is 2.5 cmH2O/L/sec. Factors that affect airways resistance include the size of the airway, its shape and the caliber. Different diseases affect those properties, altering airways resistance. COPD or chronic obstructive pulmonary disease is the most frequently encountered lung disease that increases airways resistance. * This graphic represents the relation between patient effort and its impact on ventilation under normal conditions and with disease or altered elastance and resistance. In disease more effort is requi