呼吸机波形分析课件_11

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1、WaveformMonitoringoftheMechanicallyVentilatedPatientTimOp’tHolt,Ed.D.,R.R.T.ProfessorCardiorespiratoryCareUniversityofSouthAlabamaHowventilatorworks?BasicConceptsResistance=Pressure/FlowCompliance=ΔVolume/ΔPressureFlow=Volume/TimeObjectivesDescribethevolume,

2、pressureandflowversustimescalars.Describetheuseofscalarsinthemanagementofthemechanicallyventilatedpatient.Describetheflow-volumeandpressure-volumeloopsastheyareusedinthemechanicallyventilatedpatient.Describehowloopsareusedtodiagnoseandmanageproblemsinpatient

3、sreceivingmechanicalventilationMonitoringTechniquesUsedDuringMechanicalVentilationVentilatorwaveformspressure,volumeandflowvstimescalarsflow-volumeandpressurevolumeloopsAllowsanalysisofauto-PEEP,bronchodilatorresponse,hyper-expansion,adequacyofflow,ventilato

4、rsensitivity,compliance,andleaksVentilatorWaveformsScalarsVolumeversustimePressureversustimeFlowversustimeLoopsFlow-VolumePressure-VolumeFlowversusTimeACCELERATINGDECELERATINGSINESQUAREVolumevsTimeInspirationExpirationTime(sec)Volume(ml)InspiratoryTidalVolum

5、eTIPressureversusTimeInspirationExpirationPaw(cmH2O)Time(sec)}TIPeakInspiratoryPressurePIPPEEPTEPressure-VolumeLoopControlledAssistedSpontaneousVol(ml)Paw(cmH2O)I:InspirationE:ExpirationIEEEIIFlow-VolumeLoopVolume(ml)PEFRFRCInspirationExpirationFlow(L/min)PI

6、FRVTPathologicalConditionsAirtrappingandauto-PEEPAirTrappingInspirationExpirationNormalPatientTime(sec)Flow(L/min)AirTrappingAuto-PEEP}AirTrappingInspirationExpirationVolume(ml)Flow(L/min)DoesnotreturntobaselineNormalAbnormalPathologicalConditionsIncreasedai

7、rwayresistancePaw(cmH2O)NormalNormalPPlat(NormalCompliance)IncreasedPIP}IncreasedPTA(increasedAirwayResistance)NormalPIPPPlatHighRawPIPPPlatIncreasedAirwayResistanceIncreasedAirwayResistanceInspirationExpirationVolume(ml)Flow(L/min)DecreasedPEFRNormalAbnorma

8、l“Scoopedout”patternPathologicalConditionsResponsetoBronchodilatorResponsetoBronchodilatorBeforeTime(sec)Flow(L/min)PEFRAfterLongTEHigherPEFRShorterTEPathologicalConditionsOverdistensionOverdist