呼吸麻醉教学资料呼吸曲线及环的简要介绍.ppt

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1、 呼吸曲线及环的简要介绍呼吸曲线及环的简要介绍容量压力环图容量压力环图容量时间图容量时间图容量压力图容量压力图压力时间图压力时间图流速压力环图流速压力环图流速时间图流速时间图流速压力环流速压力环压力时间图压力时间图流速时间图流速时间图流速容量环流速容量环容量时间图容量时间图流速容量环流速容量环流速容量环流速容量环容量压力环容量压力环流速压力环流速压力环顺应性=V/P阻抗=P/V.时间常数=V/V.Inadequate Inspiratory FlowFlow(L/min)Time(sec)NormalAbnormalPatients effortResponse to Bronchodilat

2、orBeforeTime(sec)Flow(L/min)PEFRAfterLong TEHigher PEFRShorter TE容量-时间曲线ExpirationVolume(ml)Inspiratory Tidal VolumePressure/volume loopPressure/volume loopVentilator work of breathingVentPatient WOBimpFCV-PCVFlow Controlled VentilationPress.Controlled VentilationSet values:PIP+PEEP;increases mean a

3、irway pressure,improves gas distribution.VT depends on R,C.inconsistent changes in VT with changes in PIP and PEEP.Low internal resistanceSpontaneous inspiration is not impairedHigh,variable inspiratory flows Cycle time or flow靠监测保正靠监测保正VT(the decelerating flow is thought to improve the distribution

4、 of gas flow;when compared to volume control ventilation there is a more rapid improvement in lung compliance and oxygenation)Set values:VT,PEEP.PIP depends on R,CHigh internal resistanceSpontaneous inspiration is impaired due to resistance,volume cycle.Limt inspiratory flowsLess atelectasis compare

5、d to pressure controlThe limited flow available may not meet the patients desired inspiratory flow rate.if the patient continues to inspire vigorously.added,unnecessary work is done,this can lead to fatigue.产生压力伤产生压力伤,容量伤容量伤,adverse hemodynamic effects不同步不同步,人机对抗人机对抗Lung Compliance Changes and the P

6、-V LoopPreset PIPVT levelsCOMPLIANCEIncreasedNormalDecreasedPressure Targeted VentilationOverdistensionVolume(ml)With little or no change in VTPaw risesNormalAbnormalAir LeakVolume(ml)Air Leak肺的顺应性C A:Resistive Work B:Elastic WorkPressure(cm H2O)Volume(ml)Increased RawPressure(cm H2O)Higher PTAAir LeakInspirationExpirationVolume(ml)Air Leak in mLNormalAbnormalAirTrappingInspirationExpirationFlow(L/min)NormalAbnormalIncreased Airway ResistanceInspirationExpirationVolume(ml)Flow(L/min)Decreased PEFRAbnormal“Scooped out”pattern机控和自控的机控和自控的P/V环变化环变化