呼吸麻醉教学呼吸曲线及环的简要介绍课件

1、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容量时间图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 FlowFlow (L/min)Time (sec)NormalAbnormalActive Inspiration or AsynchronyPatients effortResponse to Bronchodil

2、atorBeforeTime (sec)Flow (L/min)PEFRAfterLong TEHigher PEFRShorter TE容量-时间曲线InspirationExpirationTime (sec)Volume (ml)Inspiratory Tidal VolumeTIPressure/volume loop-1000100200300400500600Vol ml-505101520Paw cmH2OPressure/volume loopVentilator work of breathing-1000100200300400500600Vol ml-505101520P

3、aw cmH2OVentPatient WOBimpFCV - PCVFlow Controlled VentilationPress. Controlled VentilationSet 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 resistanceSpontaneous inspiration is not im

4、pairedHigh,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, CHigh inter

5、nal resistanceSpontaneous inspiration is impaired due to resistance,volume cycle.Limt inspiratory flowsLess atelectasis compared to pressure controlThe limited flow available may not meet the patients desired inspiratory flow rate.if the patient continues to inspire vigorously .added,unnecessary wor

6、k 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 LoopVolume (mL)Preset PIPVT levelsPaw (cm H2O)COMPLIANCEIncreasedNormalDecreasedPressure Targeted VentilationOverdistensionVolume (ml)Pressure (cm H2O)With little or no change in VTPa

7、w risesNormalAbnormalAir LeakVolume (ml)Pressure (cm H2O)Air Leak呼吸功与肺的顺应性C A: Resistive Work B: Elastic WorkPressure (cm H2O)Volume (ml)BAIncreased RawPressure (cm H2O)Higher PTANormal SlopeVol (mL)Lower SlopeAir LeakInspirationExpirationVolume (ml)Flow (L/min)Air Leak in mLNormalAbnormalAirTrappingInspirationExpirationVolume (ml)Flow (L/min)Does not returnto baselineNormalAbnormalIncreased Airway