呼吸麻醉教学资料 呼吸曲线及环的简要介绍课件

1、呼吸麻醉教学资料 呼吸曲线及环的简要介绍,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,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,2,容量压力环图,容量时间图,容量压力图,压力时间图,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,3,流速压力环图,流速时间图,流速压力环,压力时间图,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,4,流速时间图,流速容量环,流速容量环,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,5,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,呼吸麻

2、醉教学资料 呼吸曲线及环的简要介绍,6,Inadequate Inspiratory Flow,Flow (L/min,Time (sec,Normal Abnormal,Active Inspiration or Asynchrony,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,7,Response to Bronchodilator,Before,Time (sec,Flow (L/min,PEFR,After,Long TE,Higher PEFR,Shorter TE,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,8,容量-时间曲线,Inspiration,Expiration,Time (

3、sec,Volume (ml,TI,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,9,Pressure/volume loop,100,0,100,200,300,400,500,600,Vol ml,5,0,5,10,15,20,Paw cmH2O,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,10,Pressure/volume loopVentilator work of breathing,100,0,100,200,300,400,500,600,Vol ml,5,0,5,10,15,20,Paw cmH2O,Vent,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,11,FCV - PCV,Fl

4、ow 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

5、 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 in

6、spiration 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 t

7、o fatigue. 产生压力伤,容量伤,adverse hemodynamic effects 不同步,人机对抗,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,12,Lung Compliance Changes and the P-V Loop,Volume (mL,Preset PIP,VT levels,Paw (cm H2O,COMPLIANCE Increased Normal Decreased,Pressure Targeted Ventilation,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,13,Overdistension,Volume (ml,Pressure (cm H2

8、O,With little or no change in VT,Paw rises,Normal Abnormal,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,14,Air Leak,Volume (ml,Pressure (cm H2O,Air Leak,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,15,呼吸功与肺的顺应性C,A: Resistive Work B: Elastic Work,Pressure (cm H2O,Volume (ml,B,A,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,16,Increased Raw,Pressure (cm H2O,Higher PTA,Norm

9、al Slope,Vol (mL,Lower Slope,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,17,Air Leak,Inspiration,Expiration,Volume (ml,Flow (L/min,Air Leak in mL,Normal Abnormal,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,18,AirTrapping,Inspiration,Expiration,Volume (ml,Flow (L/min,Does not return to baseline,Normal Abnormal,呼吸麻醉教学资料 呼吸曲线及环的简要介绍,19,Increased Airway Res