gasman應(yīng)用在吸入麻醉教學(xué)中體會(huì)

GasMan應(yīng)用在吸入麻醉教學(xué)中的體會(huì)ExercisesWash-inofasinglecompartmentWash-inofasinglecompartmentproducesanexponentialcurveWash-inofasinglecompartmentτ=t0.63τequalsthetimerequiredforthecurvetoreach1-e-1,or63%ofitsfinalvalueAttheendof1,2,3,4,5timeconstants,thecircuittensionequals63%,87%,95%and99%ofthedeliveredfromthevaporizerWash-inofasinglecompartmentτ=V/FThetimeconstantsforwash-inofasinglecompartmentequalseffectivevolumedividedbyeffectiveinflowrateWash-inofasinglecompartmentτ=V/FCircuitvolumeis8litersτ=V/F=8/4=2minInspiredtensionreached63%ofdeliveredTwoSequentialCompartmentsBreathingcircuitpatient’slungsLung’sτ=FRC/VAFRC:functionalresidualcapacityVA:alveolarventilationTwoSequentialCompartmentsLung’sτ=FRC/VAFRC:functionalresidualcapacityVA:alveolarventilationAlveolartensioncurve(ALV)looksidenticaltotheinspiredtensioncurve(CKT)TwoSequentialCompartmentsOverpressurecanspeedtheriseinanesthetictensiontowcompartmentsawayObjective:achieve70%alveolartensionsmoothlyandquicklyAlveolarTensionCurveOpencircuitalveolartensioncurveisthealveolarresponsetoastepchangeininspiredtension,representingpatientwash-inAlveolarTensionCurveAlveolarTensionCurveInitialriseinthealveolartensioncurveisresultsfromalveolarwash-inresponsivetoastepchangeininspiredtensionAlveolarTensionCurveAlveolarTensionCurveLowerventilationslowsinitialriseinalveolartensionAlveolarTensionCurveVA：7.5----1.25τ

：0.33-----2AlveolartensionreachafinalvalueequaltoinspiredtensionundertheconditionofCO=0AlveolarTensionCurveUptakeproducesakneeandplateauinalveolartensionDisablereturn:emptyvenousanesthetictensionbar(VEN)3minpauseAlveolarTensionCurveIncreasingalveolarventilationraisesthekneeandplateau6minpauseAlveolarTensionCurveIncreasingcardiacoutputlowersthekneeandplateau9minpause7.5AlveolarTensionCurveAlveolarTensionCurveKneeorplateauheightdeterminedbytheratioofalveolarventilationtocardiacoutput?AlveolarTensionCurveAtconstantCO,increasingVAinastepwisefashioncauseastepwiseriseinalveolarplateauheightSetbreakpointsateveryminuteupto10and15Ateachminute,increaseVAbyoneAlveolarTensionCurveAtconstantVA,decreasingCOinastepwisefashioncauseastepwiseriseinalveolarplateauheightSetbreakpointsateveryminuteupto10and15Ateachminute,reduceCOby1L/minuntil0AlveolarTensionCurve105AlveolarTensionCurveKneeandplateauheightisdeterminedbytheratioofalveolarventilationtoeffectivecardiacoutputAlveolarTensionCurveAnestheticreturnedtothelungsinvenousbloodconvertsthealveolartensioncurveplateauintoagently-risingtailSetabookmarkat2minutesDeselectdisablereturncontinueAlveolarTensionCurveAscendingtailproducedbytheadditionofanestheticreturninginvenousbloodVenousanesthetictensionisdeterminedbythearterialbloodanesthetictension,tissuebloodflowandtissuecapacityBloodGasSolu