呼吸麻醉教学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,.,InadequateInspiratoryFlow,Flow(L/min),Time(sec),NormalAbnormal,ActiveInspirationorAsynchrony,ResponsetoBronchodilator,Before,Time(sec),Flow(L/min),PEFR,After,LongTE,HigherPEFR,ShorterTE,容量-时间曲线,Inspiration,Expiration,Time(sec),Volume(ml),TI,Pressure/volumeloop,-100,0,100,200,300,400,500,600,Volml,-5,0,5,10,15,20,PawcmH2O,Pressure/volumeloopVentilatorworkofbreathing,-100,0,100,200,300,400,500,600,Volml,-5,0,5,10,15,20,PawcmH2O,Vent,FCV-PCV,FlowControlledVentilation,Press.ControlledVentilation,Setvalues:PIP+PEEP;increasesmeanairwaypressure,improvesgasdistribution.VTdependsonR,C.inconsistentchangesinVTwithchangesinPIPandPEEP.LowinternalresistanceSpontaneousinspirationisnotimpairedHigh,variableinspiratoryflowsCycletimeorflow靠监测保正VT(thedeceleratingflowisthoughttoimprovethedistributionofgasflow;whencomparedtovolumecontrolventilationthereisamorerapidimprovementinlungcomplianceandoxygenation),Setvalues:VT,PEEP.PIPdependsonR,CHighinternalresistanceSpontaneousinspirationisimpairedduetoresistance,volumecycle.LimtinspiratoryflowsLessatelectasiscomparedtopressurecontrolThelimitedflowavailablemaynotmeetthepatientsdesiredinspiratoryflowrate.ifthepatientcontinuestoinspirevigorously.added,unnecessaryworkisdone,thiscanleadtofatigue.产生压力伤,容量伤,adversehemodynamiceffects不同步,人机对抗,LungComplianceChangesandtheP-VLoop,Volume(mL),PresetPIP,VTlevels,Paw(cmH2O),COMPLIANCEIncreasedNormalDecreased,PressureTargetedVentilation,Overdistension,Volume(ml),Pressure(cmH2O),WithlittleornochangeinVT,Pawrises,NormalAbnormal,AirLeak,Volume(ml),Pressure(cmH2O),AirLeak,呼吸功与肺的顺应性C,A:ResistiveWorkB:ElasticWork,Pressure(cmH2O),Volume(ml),B,A,IncreasedRaw,Pressure(cmH2O),HigherPTA,NormalSlope,Vol(mL),LowerSlope,AirLeak,Inspiration,Expiration,Volume(ml),Flow(L/min),AirLeakinmL,NormalAbnormal,AirTrapping,Inspiration,Expiration,Volume(ml),Flow(L/min),Doesnotreturntobaseline,NormalAbnormal,IncreasedAirwayResistance,