呼吸机基本波形.ppt

Company Confidential For internal use only 呼吸机基本波形呼吸机基本波形 Jay.Ding Company Confidential For internal use only 机械通气四大变量机械通气四大变量 流量 压力 容量 时间 定流通气 变流通气 Company Confidential For internal use only 吸气流量波吸气流量波机控呼吸机控呼吸 呼吸机送气开始 吸气峰流量 吸呼切换 吸气时间 整个呼吸周期时间（TCT）Company Confidential For internal use only 漏气对切换的影响漏气对切换的影响 Company Confidential For internal use only 双重切换双重切换 Company Confidential For internal use only 延迟时间效应延迟时间效应 Company Confidential For internal use only 管路回缩力管路回缩力 Company Confidential For internal use only 不同的流量波型不同的流量波型 Company Confidential For internal use only 吸气流量波吸气流量波自主呼吸自主呼吸 吸气开始 最大吸气流量 吸气结束 吸气时间 Company Confidential For internal use only 一次吸气过程中出现了病人吸气动作，通常在流量波形上会出现切迹，此时病人不会得到所需的流量 Company Confidential For internal use only 按需流量补偿按需流量补偿 Company Confidential For internal use only 呼气流量波呼气流量波 呼气流量波的大小、持续时间、形状取决于顺应性和阻力 呼气开始 呼气峰流量 呼气结束 呼气流量的持续时间 有效呼气时间 TCT 整个呼吸周期时间 Company Confidential For internal use only 气道阻力增大气道阻力增大 Company Confidential For internal use only 被动呼气和主动呼气被动呼气和主动呼气 Company Confidential For internal use only 压力曲线压力曲线 Company Confidential For internal use only 吸气暂停吸气暂停 Company Confidential For internal use only 阻力、流量、顺应性影响（固定潮气量）阻力、流量、顺应性影响（固定潮气量）Company Confidential For internal use only PEEP/CPAP Company Confidential For internal use only 气道压和肺泡压气道压和肺泡压 Company Confidential For internal use only Company Confidential For internal use only 平均气道压平均气道压 Company Confidential For internal use only 自主触发自主触发 Company Confidential For internal use only 未达到触发灵敏度未达到触发灵敏度 Company Confidential For internal use only 未能触发辅助通气的呼吸时，时间的测算也会受到影响。Company Confidential For internal use only 压力上升时间压力上升时间 Company Confidential For internal use only PCV/PSV Company Confidential For internal use only 双水平正压通气下的压力曲线双水平正压通气下的压力曲线 两个不同水平的PEEP交替使用 Phigh，Plow，Thigh，Tlow 参数的不同组合和病人自主呼吸的情况，可衍生出几种不同的模式 Company Confidential For internal use only APRV Company Confidential For internal use only 食道压食道压 测量食道压，需要放置测压管进入病人食道，由于食道内消化液的关系，最好采用带套囊的盲端测压管 Company Confidential For internal use only 食道测压管最好放置在右心房的后侧 Company Confidential For internal use only Company Confidential For internal use only Company Confidential For internal use only 容量容量-时间曲线时间曲线 Company Confidential For internal use only 自动管路顺应性补偿自动管路顺应性补偿 Company Confidential For internal use only 压力压力容量环容量环 Company Confidential For internal use only Company Confidential For internal use only 气道压和气管内压气道压和气管内压 Company Confidential For internal use only Paw实线代表呼吸机端(气管插管远端)所反映的P-V环，包含了气管插管所导致的阻力。Ptrach虚线代表总气管内(气管插管末端)所反映的P-V环，排除了气管插管所引起的阻力因素。测Ptrach另需用2mm的细导管经气管插管插至气管导管外 Company Confidential For internal use only 静态压力容量环静态压力容量环 Company Confidential For internal use only 流量流量-容量环容量环 Company Confidential For internal use only 方波和递减波方波和递减波 Company Confidential For internal use only 压力压力-流量环流量环 临床使用较少 Company Confidential For internal use only