談?wù)労粑鼨C(jī)演示教學(xué)課件

選談呼吸ICU張禎選談呼吸1呼吸機(jī)是什么使用呼吸機(jī)是利用機(jī)械進(jìn)行人工通氣來維持和改善呼吸的一種支持治療措施●人工肺●實(shí)質(zhì)-氣泵CLUR,SOHUCDM呼吸機(jī)是什么2使用呼吸機(jī)的指征1呼吸頻率>30-35次/分,或<510次/分2.鼻導(dǎo)管鼻塞或面罩吸氧血?dú)夥治?Po60mmHgoXPCo,>55mmHg3.COPD:P0,<55-60mmHgEXPCO,>70-80mmHg使用呼吸機(jī)的指征3呼吸機(jī)的作用1利用呼吸機(jī)本身的機(jī)械動(dòng)作人工地幫助人吸氣和呼氣2它不能替代肺呼吸的生理作用a通氣作用一氣體的吸入和呼出(呼吸機(jī)的作用在于此)b換氣作用-吸收o2和排出CO23使用呼吸機(jī)目的a呼吸支持一維持正常的通氣b呼吸治療一糾正通氣衰竭,間接糾正換氣衰竭最終的作用是提高氧分壓(Pao2和維持正常、降低CO2分壓(PacO,)呼吸機(jī)的作用4機(jī)械通氣的并發(fā)癥●氣壓傷●相關(guān)性肺炎減少心排血量腦水腫機(jī)械通氣的并發(fā)癥5機(jī)械通氣的禁忌癥●肺大皰和肺囊腫●急性心肌梗死●低血壓和休克●咯血●活動(dòng)性肺結(jié)核機(jī)械通氣的禁忌癥6機(jī)械通氣的方式●有創(chuàng)通氣無創(chuàng)通氣機(jī)械通氣的方式7呼吸機(jī)常用參數(shù)潮氣量呼吸頻率吸氣壓力Pi流速吸入氧濃度FF102呼吸機(jī)吸氣觸發(fā)吸呼比trigger呼氣時(shí)間呼氣末正壓PEEP斜率吸氣時(shí)間壓力支持RampPASB/PSv呼吸機(jī)常用參數(shù)8潮氣量VT●正常值6---8ml/kg●VT越大,PlatLorrin越高M(jìn)=900ml潮氣量VT9呼吸頻率RRmbaressurecuRve制通氣時(shí),常設(shè)12-20bpmTins不變時(shí)RR越快,呼氣時(shí)間越短lowcurve保證足夠的呼氣時(shí)呼吸頻率RR10談?wù)労粑鼨C(jī)演示教學(xué)課件11談?wù)労粑鼨C(jī)演示教學(xué)課件12談?wù)労粑鼨C(jī)演示教學(xué)課件13談?wù)労粑鼨C(jī)演示教學(xué)課件14談?wù)労粑鼨C(jī)演示教學(xué)課件15談?wù)労粑鼨C(jī)演示教學(xué)課件16談?wù)労粑鼨C(jī)演示教學(xué)課件17談?wù)労粑鼨C(jī)演示教學(xué)課件18談?wù)労粑鼨C(jī)演示教學(xué)課件19談?wù)労粑鼨C(jī)演示教學(xué)課件20談?wù)労粑鼨C(jī)演示教學(xué)課件21談?wù)労粑鼨C(jī)演示教學(xué)課件22談?wù)労粑鼨C(jī)演示教學(xué)課件23談?wù)労粑鼨C(jī)演示教學(xué)課件24談?wù)労粑鼨C(jī)演示教學(xué)課件25談?wù)労粑鼨C(jī)演示教學(xué)課件26談?wù)労粑鼨C(jī)演示教學(xué)課件27談?wù)労粑鼨C(jī)演示教學(xué)課件28談?wù)労粑鼨C(jī)演示教學(xué)課件29談?wù)労粑鼨C(jī)演示教學(xué)課件30談?wù)労粑鼨C(jī)演示教學(xué)課件31談?wù)労粑鼨C(jī)演示教學(xué)課件32談?wù)労粑鼨C(jī)演示教學(xué)課件33談?wù)労粑鼨C(jī)演示教學(xué)課件34談?wù)労粑鼨C(jī)演示教學(xué)課件35談?wù)労粑鼨C(jī)演示教學(xué)課件36談?wù)労粑鼨C(jī)演示教學(xué)課件37談?wù)労粑鼨C(jī)演示教學(xué)課件38談?wù)労粑鼨C(jī)演示教學(xué)課件39談?wù)労粑鼨C(jī)演示教學(xué)課件40談?wù)労粑鼨C(jī)演示教學(xué)課件41談?wù)労粑鼨C(jī)演示教學(xué)課件42談?wù)労粑鼨C(jī)演示教學(xué)課件43談?wù)労粑鼨C(jī)演示教學(xué)課件44談?wù)労粑鼨C(jī)演示教學(xué)課件45談?wù)労粑鼨C(jī)演示教學(xué)課件46談?wù)労粑鼨C(jī)演示教學(xué)課件47談?wù)労粑鼨C(jī)演示教學(xué)課件48談?wù)労粑鼨C(jī)演示教學(xué)課件49談?wù)労粑鼨C(jī)演示教學(xué)課件50談?wù)労粑鼨C(jī)演示教學(xué)課件51談?wù)労粑鼨C(jī)演示教學(xué)課件52談?wù)労粑鼨C(jī)演示教學(xué)課件53談?wù)労粑鼨C(jī)演示教學(xué)課件54談?wù)労粑鼨C(jī)演示教學(xué)課件55談?wù)労粑鼨C(jī)演示教學(xué)課件56談?wù)労粑鼨C(jī)演示教學(xué)課件57談?wù)労粑鼨C(jī)演示教學(xué)課件58談?wù)労粑鼨C(jī)演示教學(xué)課件59談?wù)労粑鼨C(jī)演示教學(xué)課件60談?wù)労粑鼨C(jī)演示教學(xué)課件61談?wù)労粑鼨C(jī)演示教學(xué)課件62談?wù)労粑鼨C(jī)演示教學(xué)課件63談?wù)労粑鼨C(jī)演示教學(xué)課件64談?wù)労粑鼨C(jī)演示教學(xué)課件65談?wù)労粑鼨C(jī)演示教學(xué)課件66談?wù)労粑鼨C(jī)演示教學(xué)課件67談?wù)労粑鼨C(jī)演示教學(xué)課件68談?wù)労粑鼨C(jī)演示教學(xué)課件69談?wù)労粑鼨C(jī)演示教學(xué)課件70談?wù)労粑鼨C(jī)演示教學(xué)課件71談?wù)労粑鼨C(jī)演示教學(xué)課件72談?wù)労粑鼨C(jī)演示教學(xué)課件73談?wù)労粑鼨C(jī)演示教學(xué)課件74談?wù)労粑鼨C(jī)演示教學(xué)課件75談?wù)労粑鼨C(jī)演示教學(xué)課件76談?wù)労粑鼨C(jī)演示教學(xué)課件77談?wù)労粑鼨C(jī)演示教學(xué)課件78談?wù)労粑鼨C(jī)演示教學(xué)課件79談?wù)労粑鼨C(jī)演示教學(xué)課件80談?wù)労粑鼨C(jī)演示教學(xué)課件81談?wù)労粑鼨C(jī)演示教學(xué)課件82談?wù)労粑鼨C(jī)演示教學(xué)課件83談?wù)労粑鼨C(jī)演示教學(xué)課件84談?wù)労粑鼨C(jī)演示教學(xué)課件85談?wù)労粑鼨C(jī)演示教學(xué)課件86談?wù)労粑鼨C(jī)演示教學(xué)課件87談?wù)労粑鼨C(jī)演示教學(xué)課件88談?wù)労粑鼨C(jī)演示教學(xué)課件89談?wù)労粑鼨C(jī)演示教學(xué)課件90談?wù)労粑鼨C(jī)演示教學(xué)課件91談?wù)労粑鼨C(jī)演示教學(xué)課件92談?wù)労粑鼨C(jī)演示教學(xué)課件93談?wù)労粑鼨C(jī)演示教學(xué)課件94談?wù)労粑鼨C(jī)演示教學(xué)課件95談?wù)労粑鼨C(jī)演示教學(xué)課件96談?wù)労粑鼨C(jī)演示教學(xué)課件97談?wù)労粑鼨C(jī)演示教學(xué)課件98談?wù)労粑鼨C(jī)演示教學(xué)課件99談?wù)労粑鼨C(jī)演示教學(xué)課件100談?wù)労粑鼨C(jī)演示教學(xué)課件101談?wù)労粑鼨C(jī)演示教學(xué)課件102談?wù)労粑鼨C(jī)演示教學(xué)課件1