小兒麻醉ppt課件(2)(編輯修改稿)
2025-05-26 01:02 本頁面
【文章內(nèi)容簡介】 ,器械死腔應(yīng)小 ,無論是無活辧或低阻力活辧 ,其阻力要低 ,回路內(nèi)部的氣體容積要小 ,應(yīng)盡可能減少 co2重復(fù)吸入 ,呼吸作功宜小 ,以免呼吸肌疲勞 ,其結(jié)構(gòu)形成的揣流要小 .在臨床中 ,年長兒和青少年大多數(shù)手術(shù)能使用標(biāo)準(zhǔn)的成人呼吸回路 ,然而在嬰幼兒 ,特別是 10kg以下的嬰兒 ,應(yīng)選用為兒童設(shè)計(jì)的呼吸回路 .19MaplesonAtheMagillandLackcircuitsMaplesonBandCRebreathingofexhaledgasesoccursevenwhenveryhighfreshgasflowratesareused,sinceinspirationistakenfromthesamespaceintowhichthepreviousbreathwasexpired.Theseareunsatisfactoryforanaesthesia,butmaybeusedinemergencyforresuscitation.MaplesonDthemodifiedBaincircuit.MaplesonEAyre39。sTpieceMaplesonFnotoriginallyclassifiedbyMapleson,butisusedtorefertoJacksonRees39。modificationofAyre39。sTpiece.TheHumphreyADEcircuitprovidestheabilitytoswitchbetweentheMaplesonA,DandEarrangements. 20AthreewayTtubewhoselimbsareconnectedto(F)thefreshgassupplyfromtheanaesthesiamachine,(R)alengthofcorrugatedreservoirtubeand(P)thepatientconnector.Ithasminimaldeadspace,novalvesandminimalresistance.theMaplesonEsystemsuggestedthatagasflowrateofto3timestheminutevolumewasrequiredtopreventrebreathingofexpiredgas.JacksonRees39。modificationoftheAyre39。sTpiece(somethimesknownastheMaplesonFsystem)connectsatwoendedbagtotheexpiratorylimbofthecircuit,gasescapingviathe`tail39。ofthebagAyre39。s TPiece21BaincircuitfunctionsinthesamewayastheTpiece,exceptthatthetubesupplyingfreshgastothepatientislocatedinsidethereservoirtubeThecircuitmaybeattachedtoablockassemblywithapopoffvalveandmounteddirectlyt
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