呼吸麻醉教学资料呼吸曲线及环的简要介绍

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容量环流速时间图流速容量环容量时间图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.InadequateInspiratoryFlowFlow(L/min)Time(sec)NormalAbnormalActiveInspirationorAsynchronyPatient’seffortResponsetoBronchodilatorBefore01Time(sec)02Flow(L/min)03PEFR04After05LongTE06HigherPEFR07ShorterTE08容量-时间曲线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靠监测保正VT(thedeceleratingflowisthoughttoimprovethedistributionofgasflow;whencomparedtovolumecontrolventilationthereisamorerapidimprovementinlungcomplianceandoxygenation)Setvalues:VT,PEEP.PIPdependsonR,CHighinternalresistanceSpontaneousinspirationisimpairedduetoresistance,volumecycle.LimtinspiratoryflowsLessatelectasiscomparedtopressurecontrolThelimitedflowavailablemaynotmeetthepatient‘sdesiredinspiratoryflowrate.ifthepatientcontinuestoinspirevigorously.added,unnecessaryworkisdone,thiscanleadtofatigue.

产生压力伤,容量伤,adversehemodynamiceffects不同步,人机对抗LungComplianceChangesandtheP-VLoopVolume(mL)1PresetPIP2VTlevels3Paw(cmH2O)4COMPLIANCEIncreasedNormalDecreased5PressureTargetedVentilation61Volume(ml)2Pressure(cmH2O)3WithlittleornochangeinVT4Pawrises5NormalAbnormalOverdistensionVolume(ml)Pressure(cmH2O)AirLeakAirLeak呼吸功与肺的顺应性C01ResistiveWorkElasticWorkPressure(cmH2O)Volume(ml)BA02030405062018Pressure(cmH2O)012019HigherPTA022020NormalSlope032021Vol(mL)042022LowerSlope05IncreasedRawAirLeak01Inspiration02Expiration03Volume(ml)04Flow(L/min)05AirLeakinmL06NormalAbnormal07AirTrappingInspirationExpirationVolume(ml)Flow(L/min)DoesnotreturntobaselineNormalAbnormalI