機械通氣模式(參考版)
2025-03-11 11:08本頁面
【正文】 機械通氣的輔助措施 ? 一氧化氮 /前列腺素吸入 ? 氣道或胸壁震蕩 ? 氣管內吹氣 ? 部分液體通氣 ? 體外膜肺 ? 體外二氧化碳清除 ? 血管內氧合 ? 容許性高碳酸血癥 ? 附臥位機械通氣 謝謝觀看 /歡迎下載 BY FAITH I MEAN A VISION OF GOOD ONE CHERISHES AND THE ENTHUSIASM THAT PUSHES ONE TO SEEK ITS FULFILLMENT REGARDLESS OF OBSTACLES. BY FAITH I BY FAITH 。 相對禁忌證 ? （ 1）低血容量狀態(tài) ? （ 2）單側肺損傷 ? （ 3）近期內行肺切除術后 ? （ 4）顱內高壓。 （ 7）手術后應用預防術后肺不張 （ 8）嚴重的雙側彌漫性肺部炎癥（ 9）新生兒呼吸窘迫綜合征。 ? 當 PEEP水平超過 15cmH2O時，對循環(huán)功能產生干擾，此時應按上述目標尋找一個合適的 PEEP。 ?高水平 PEEP： 20cmH2O，大約對 20%左右的嚴重 ALI/ARDS患者可能有效。 其他幾種新的通氣模式 ?比例輔助通氣（ PAV） ?壓力增強通氣 ?分鐘指令通氣（ MVV） ?氣道壓力釋放通氣（ APRV） ?壓力調節(jié)容量控制通氣（ PRVCV） ?容積支持通氣（ VSV） Then What Is APRV? APRV is similar but utilizes a very short expiratory time for PRESSURE RELEASE this short time at low pressure allows for ventilation APRV always implies an inverse I:E ratio All spontaneous breathing is done at upper pressure level Spontaneous Breaths P T “ Release” Clinical Advantages To APRV Results in lower PIP at similar MAP (CPAP w/ release) Spontaneous breathing and synchronized transitions can lead to increased Patient Comfort and Synchrony Substantially more literature than any other new mode Synchronized Transitions Spontaneous Breath P T PEEPH PEEPL APRV Literature Results All studies but one showed similar gas exchange and pulmonary mechanics resulted in lower PIP at similar MAP (CPAP w/ release) Other studies utilized . 2 seconds and slight AutoPEEP if 2 sec. was used resulted in deterioration of gas exchange P T
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