无创呼吸机床应用操作要点.pptVIP

IPAP/EPAP 潮气量 2lpmO2 4lpmO2 10lpmO2 10/5 15/5 300 600 300 600 36.3 37.4 35.2 34.1 51.7 51.7 47.3 50.6 47.8 81.4 47.8 80.3 吸入氧流量与病人吸入氧浓度的关系 注：给氧位置在鼻罩处 CO2潴留改善不明显 支持压力不够 漏气量不够 EPAP过低 合并OSA 分泌物？ 其它治疗？ 治疗时间？ 增大压差 适当增大漏气量 IPAP低于15cmH2O时采用PEV排气阀 适当调节EPAP，抵消PEEPi 夜间进行压力滴定 调整其它治疗 给予足够的治疗时间 原因 解决方法 150 80 60 40 20 PaCO2 mm Hg （5） 4 VA（L） 高碳酸血症程度与肺泡通气量的关系 无创通气的感染机会 鼻 罩 鼻 孔 清洁良好 (n=13) 清洁不良 (n=27) 1 (7.7%) 5 (12.5%) 1 (7.7%) 9 (22.5%) 不同清洁水平致病微生物分离情况 Arch Bronconeumol 2004;40(9):392-6 避免无创通气交叉感染 及时清洁鼻罩、管道及湿化器 及时清洗和更换空气过滤棉 使用低阻力细菌过滤器 小 结 适应征广泛 安全有效，操作十分简单 可使急性插管率下降70%左右 对急、慢性呼衰、心衰及OSA，疗效显著 肺、心康复的有效手段 无创通气具有以下优势： * Before we get started, it is important to remember one thing, “All Noses are Not Created Equal”. Each person is an individual and each individual has a nose that is unique to themselves. However, with innovative design and technology, Respironics Comfort Series can fit most noses with just a few sizes. And, for those hard to fit noses, we’ve got those covered as well. * * Confidential Sector, MMMM dd, yyyy, Reference “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician or other health care professional.” Confidential Sector, MMMM dd, yyyy, Reference “This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information i