最新呼吸机波形分析幻灯片.ppt

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1、呼吸机波形分析Howventilatorworks?BasicConceptsResistance=Pressure/FlowCompliance=ΔVolume/ΔPressureFlow=Volume/TimeFlowversusTimeACCELERATINGDECELERATINGSINESQUAREVolumevsTimeInspirationExpirationTime(sec)Volume(ml)InspiratoryTidalVolumeTIPressureversusTimeInspirationExpirationPaw(cmH2O)Time(sec)}TIPeakIns

2、piratoryPressurePIPPEEPTEPressure-VolumeLoopControlledAssistedSpontaneousVol(ml)Paw(cmH2O)I:InspirationE:ExpirationIEEEIIFlow-VolumeLoopVolume(ml)PEFRFRCInspirationExpirationFlow(L/min)PIFRVTPathologicalConditionsAirtrappingandauto-PEEPAirTrappingInspirationExpirationNormalPatientTime(sec)Flow(L/mi

3、n)AirTrappingAuto-PEEP}AirTrappingInspirationExpirationVolume(ml)Flow(L/min)DoesnotreturntobaselineNormalAbnormalPathologicalConditionsIncreasedairwayresistancePaw(cmH2O)NormalNormalPPlat(NormalCompliance)IncreasedPIP}IncreasedPTA(increasedAirwayResistance)NormalPIPPPlatHighRawPIPPPlatIncreasedAirw

4、ayResistanceIncreasedAirwayResistanceInspirationExpirationVolume(ml)Flow(L/min)DecreasedPEFRNormalAbnormal“Scoopedout”patternPathologicalConditionsResponsetoBronchodilatorResponsetoBronchodilatorBeforeTime(sec)Flow(L/min)PEFRAfterLongTEHigherPEFRShorterTEPathologicalConditionsOverdistensionOverdist

5、ensionVolume(ml)Pressure(cmH2O)WithlittleornochangeinVTPawrisesNormalAbnormalPathologicalConditionsInadequateInspiratoryFlow(AirHungary)InadequateInspiratoryFlowAdequateFlowTime(sec)InadequateFlowPaw(cmH2O)InadequateInspiratoryFlowFlow(L/min)Time(sec)NormalAbnormalActiveInspirationorAsynchronyPatie

6、nt’seffortPathologicalConditionsInadequateSensitivityInadequateSensitivityVolume(mL)Paw(cmH2O)IncreasedWOBPathologicalConditionsDecreasedComplianceDECREASEDCOMPLIANCETime(sec)Paw(cmH2O)LowCompliancePIPPPlatNormalPIPPPlatNormalPPlat(NormalCompliance)IncreasedPPlat(DecreasedCompliance)NormalPIPLungCo

7、mplianceChangesandtheP-VLoopVolume(mL)PresetPIPVTlevelsPaw(cmH2O)COMPLIANCEIncreasedNormalDecreasedPressureTargetedVentilationPathologicalConditionsAirLeakAirLeakVolume(ml)Time(sec)AirLeakAirLeakVolume(ml)P