【文章內(nèi)容簡介】 麻醉監(jiān)測 ContentCentral Venous Pressure ⑶ Subclavian vein. This approach is more hazardous than the internal jugular, however, it is the most suitable route if longterm cannulation is contemplated. 預(yù)期、企圖 向饑婁腋生繹鐮算嘛串糧貯諱接陀源刀浚硫唁登嶄東垣雪簍凈皆永嚏炭弄第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 ContentCentral Venous Pressure Whichever route is chosen, meticulous（一絲不茍的，小心翼翼的） attention to antisepsis（抗感染） is necessary. The tip of the catheter should lie above the level of the pericardium（心包） to minimize the risk of erosion（侵蝕） through the wall of the right atrium. 歌菊突芯坪萄天噎宿找翁契啃廟錦埔漿帆百撈湃汁沛架撼鴻淚羚誹范曉綜第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Pulmonary Artery Pressure Monitoring In some clinical situations, the central venous or right atrial pressure does not correlate with pressure in the left atrium. Dissociation between left atrial and central venous pressure occurs in the situations: 鞭說無鶴酌祝煎脅卸謄詫瘍宇但旦鉆語稈淚頸陽除喚貢龐瘴弱背酗檻女劉第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Pulmonary Artery Pressure Monitoring ⑴ left ventricular(心室 ) failure with pulmonary edema(肺水腫 ). ⑵ interstitial pulmonary edema of any etiology. ⑶ chronic pulmonary disease. ⑷ valvular heart disease. The pulmonary artery catheter is inserted via a central vein, usually the internal jugular or subclavian. 堪鍛募葦佑脅勿曝曲勤堆庚孝俗舊舍虜黔惰識塢顴仇嚨哄街祁萬直市瘸問第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Pulmonary Artery Pressure Monitoring Use of the pulmonary artery catheter includes the following: ⑴ the assessment of the volume status of the patient in conditions where CVP is unreliable. 筍冀熔郵借琺鳴揩方貸逢慘淄怒興蛾甄覺絹潦煽寥晴牢棚柿爆孵想極寵嬸第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 ⑵ sampling of mixed venous blood in order to calculate shunt fraction(分流分數(shù) ). ⑶ measurement of cardiac output using the thermodilution（熱稀釋法） . ⑷ derivation of other cardiovascular indices. 喬跺峭溫疫襟捷斬償叁項晚鋪粗睦津蘇馴氫馭步媚暇漂雪飽盾寵事東砍矣第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Cardiac Output There are noninvasive measure cardiac output: thoracic impedance cardiography（胸部心阻抗血流圖） , doppler systems. 熒駝故令宦頤援欲棋架揣弟鈴俘瘡芍卑洱呆田恍懷幟豬燴陣迎斤磚匆核坍第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Blood Loss Losses of up to 10℅ of blood volume are tolerated well and may be replaced by an appropriate volume of crystalloid solution（晶體液） . Blood loss in excess of 15℅ of blood volume during surgery should be replaced by blood. 突芥囑亦拔劫哮獅蚊似哥唆蚜注緯騎檄籮鋇涯壓移襄寶瀝熙慰渣撬咱燥造第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 謠財堅椽禽洲廓津史盂品竣蹋洽蜜肖幸瓦濘洲犀揚侖容問嘗畝憲勝思唱賽第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Respiratory System 酬蠱便精窯摘霉媒燥作想憊鉑印氛灑朝移寐考倆逢椽閏股銅傳鴉妄謹辛躍第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Oesophageal Stethoscope The oesophageal stethoscope is simple, cheap, safe, noninvasive and free from electrical interference. 匝修慢痹目汽蛹唱踐清拎程趕匙嫉壟晶沒耘人壯舊嘻臣卷鍵罕徑諒聾猶菇第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Measurement of Airway Pressure Airway pressure may reflect changes in lung and chest wall pliance if the ventilator is of the volumecycled or timecycled volumepreset variety. 以軟蓄扶江投駕斯儈瓜酉尾談言周樸拽塹凈靡汕澀鐮針時篇圭爛先湊周肘第11章 麻醉監(jiān)測第11章 麻醉監(jiān)測 Content Disconnection Alarm When the lungs are ventilated mechanically,