呼吸麻醉教学资料呼吸曲线及环的简要介绍.ppt

波型 流速-时间曲线 压力-时间曲线 容量-时间曲线 图形 压力-容量环 流速-容量环 流速-容量环,呼吸曲线及环的简要介绍,容量压力环图,容量时间图,容量压力图,压力时间图,流速压力环图,流速时间图,流速压力环,压力时间图,流速时间图,流速容量环,流速容量环,流速容量环,容量压力环,流速压力环,顺应性 = V/ P,阻抗 = P/ V,.,时间常数 = V/ V,.,Inadequate Inspiratory Flow,Flow (L/min),Time (sec),Normal Abnormal,Active Inspiration or Asynchrony,Response to Bronchodilator,Before,Time (sec),Flow (L/min),PEFR,After,Long TE,Higher PEFR,Shorter TE,容量-时间曲线,Inspiration,Expiration,Time (sec),Volume (ml),TI,Pressure/volume loop,-100,0,100,200,300,400,500,600,Vol ml,-5,0,5,10,15,20,Paw cmH2O,Pressure/volume loop Ventilator work of breathing,-100,0,100,200,300,400,500,600,Vol ml,-5,0,5,10,15,20,Paw cmH2O,Vent,FCV - PCV,Flow Controlled Ventilation,Press. Controlled Ventilation,Set values: PIP+PEEP;increases mean airway pressure,improves gas distribution. VT depends on R, C.inconsistent changes in VT with changes in PIP and PEEP. Low internal resistance Spontaneous inspiration is not impaired High,variable inspiratory flows Cycle time or flow 靠监测保正VT(the decelerating flow is thought to improve the distribution 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, C High internal resistance Spontaneous inspiration is impaired due to resistance,volume cycle. Limt inspiratory flows Less atelectasis compared to pressure control The 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,容量伤,adverse hemodynamic effects 不同步,人机对抗,Lung Compliance Changes and the P-V Loop,Volume (mL),Preset PIP,VT levels,Paw (cm H2O),COMPLIANCE Increased Normal Decreased,Pressure Targeted Ventilation,Overdistension,Volume (ml),Pressure (cm H2O),With little or no change in VT,Paw rises,Normal Abnormal,Air Leak,Volume (ml),Pressure (cm H2O),Air Leak,呼吸功与肺的顺应性C,A: Resistive Work B: Elastic Work,Pressure (cm H2O),Volume (ml),B,A,Increased Raw,Pressure (cm H2O),Higher PTA,Normal Slope,Vol (mL),Lower Slope,Air Leak,Inspiration,Expiration,Volume (ml),Flow (L/min),Air Leak in mL,Normal Abnormal,AirTrapping,Inspiration,Expiration,Volume (ml),Flow (L/min),Does not return to baseline,Normal Abnormal,Increased Airway Resis