PB840双重模式PPT.ppt

什么是双重模式?;;临床医生选择容量通气大体上有三个原因;双重模式到底有什么好处？;;Flow;Flow;定容通气与定压通气的比较 区别 – 对顺应性和病人需求增加时的反应;典型的容量通气和压力通气的比较对自主呼吸努力的反应;;辅助通气呼吸方式;;如何启动 VC+?;VC+ - 参数设定;参数设定;示例－VC+ 设置;840 VV+ 采用的压力校正算法;840 VV+ 的启动;840 VV+ 启动;VC+ Startup Example;VC+压力校正算法;840 VV+ 采用的压力校正算法;VC+ 压力调节以保持预设潮气量;840 VV+ 断开/重新连接算法;VC+ - 断开/重新连接示例;防止不适当的通气支持;新增的报警与840现有的报警有所不同;可输送的最大潮气量;VC+ -示例：保护性算法防止VT过大;诸位何时才能认为 VC+比压力控制要好呢？;文献报道?;Crit Care 1997; 1 (2): 75 77A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure Henrik?Guldager2, Soeren L?Nielsen1, Peder?Carl1, and Mogens B?Soerensen1 PIP was lower for all patients using the PRVC mode compared to the VC mode, and alveolar ventilation was unchanged as indicated by the constant PaCO2. The new mode of ventilation did not improve outcome or duration of treatment, despite a statistically significant difference in peak pressures (4 cmH2O). Though this difference in peak pressure is small, it may be more relevant in situations where larger tidal volumes are contemplated. ;A recent review recommends pressure-control ventilation in all clinical circumstances requiring artificial ventilation. During PRVC, as with pressure control, there is a maximum pressure difference between the ventilator and the lung at the beginning of the inspiratory cycle. The resulting flow is also maximal. With the increase in intrathoracic pressure this difference diminishes, as does the resulting inspiratory flow. The flow pattern is therefore called decelerating inspiratory flow. In VC ventilation, there is a constant inspiratory flow and the resulting intrathoracic pressure is always increasing. Pressure-regulated ventilation is therefore capable of delivering the same volume at a lower PIP. This fact may play a more significant role when higher tidal volumes are required, and greater differences in peak pressures between PRVC and VC may be expected. ;840 VC+ Benefits;VC+ 和自主呼吸;VC+ - 可能有助于达到临床目标;典型的强制性“双重模式”的局限性;Target volume (50