呼吸麻醉教學(xué)資料呼吸曲線及環(huán)的簡要介紹

波型流速-時間曲線壓力-時間曲線容量-時間曲線圖形壓力-容量環(huán)流速-容量環(huán)流速-容量環(huán)

呼吸曲線及環(huán)的簡要介紹容量壓力環(huán)圖容量時間圖容量壓力圖壓力時間圖流速壓力環(huán)圖流速時間圖流速壓力環(huán)壓力時間圖流速容量環(huán)流速時間圖流速容量環(huán)容量時間圖流速容量環(huán)容量壓力環(huán)流速壓力環(huán)順應(yīng)性=V/P阻抗=P/V.時間常數(shù)=V/V.InadequateInspiratoryFlowFlow(L/min)Time(sec)NormalAbnormalActiveInspirationorAsynchronyPatient’seffortResponsetoBronchodilatorBefore01Time(sec)02Flow(L/min)03PEFR04After05LongTE06HigherPEFR07ShorterTE08容量-時間曲線InspirationExpirationTime(sec)Volume(ml)InspiratoryTidalVolumeTIPressure/volumeloop-1000100200300400500600Vol[ml]-505101520Paw[cmH2O]Pressure/volumeloop

Ventilatorworkofbreathing-1000100200300400500600Vol[ml]-505101520Paw[cmH2O]VentPatientWOBimpFCV-PCVFlowControlledVentilationPress.ControlledVentilationSetvalues:PIP+PEEP;increasesmeanairwaypressure,improvesgasdistribution.VTdependsonR,C.inconsistentchangesinVTwithchangesinPIPandPEEP.LowinternalresistanceSpontaneousinspirationisnotimpairedHigh,variableinspiratoryflows

Cycletimeorflow靠監(jiān)測保正VT(thedeceleratingflowisthoughttoimprovethedistributionofgasflow;whencomparedtovolumecontrolventilationthereisamorerapidimprovementinlungcomplianceandoxygenation)Setvalues:VT,PEEP.PIPdependsonR,CHighinternalresistanceSpontaneousinspirationisimpairedduetoresistance,volumecycle.LimtinspiratoryflowsLessatelectasiscomparedtopressurecontrolThelimitedflowavailablemaynotmeetthepatient‘sdesiredinspiratoryflowrate.ifthepatientcontinuestoinspirevigorously.added,unnecessaryworkisdone,thiscanleadtofatigue.

產(chǎn)生壓力傷,容量傷,adversehemodynamiceffects不同步,人機(jī)對抗LungComplianceChangesandtheP-VLoopVolume(mL)1PresetPIP2VTlevels3Paw(cmH2O)4COMPLIANCEIncreasedNormalDecreased5PressureTargetedVentilation61Volume(ml)2Pressure(cmH2O)3WithlittleornochangeinVT4Pawrises5NormalAbnormalOverdistensionVolume(ml)Pressure(cmH2O)AirLeakAirLeak呼吸功與肺的順應(yīng)性C01ResistiveWorkElasticWorkPressure(cmH2O)Volume(ml)BA02030405062018Pressure(cmH2O)012019HigherPTA022020NormalSlope032021Vol(mL)042022LowerSlope05IncreasedRawAirLeak01Inspiration02Expiration03Volume(ml)04Flow(L/min)05AirLeakinmL06NormalAbnormal07AirTrappingInspirationExpirationVolume(ml)Flow(L/min)DoesnotreturntobaselineNormalAbnormalI