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基础模式的PPT分享

  • 2026-04-06 11:57:22
基础模式的PPT分享
这是4.15的PPT分享，关于机械通气的基础模式
机械通气的分类：有创，无创，高流量氧疗
目前的有创通气模式，包括了容控，压控，PRVC，容量支持，压力支持，CPAP，SIMV的各种组合，还有APRV。本文仅分享常用的基础模式：VC,PC,PRVC,PS,APRV。
控制通气模式：现代呼吸机的控制模式，都是以控制/辅助方式实现，而非传统的完全控制送气的方式实现。
容控（VC）：按照设定的送气时间，完成目标潮气量的送气。送气波形为方波（气流量恒定），送气压力改变，需要设定压力报警
压控（PC）：按照设定的送气时间，以维持目标压力完成送气。送气波形为递减波（压差减小），送气潮气量随着气道阻力和顺应性的改变而改变
PRVC：设定目标潮气量，呼吸机自动调整送气压力，对比送出的潮气量和目标潮气量的差异，自动调整送气压力（人手调整压控以达到目标潮气量的做法，呼吸机自动调整实现）
潮气量：以患者的理想体重计算，普博呼吸机内置理想体重计算器，启用时输入患者身高，可自动计算理想体重，在呼吸机的显示中，也有以ml/kg(PBW)显示。更直观的了解潮气量的设置及实现情况。
一般目标潮气量：6-8ml/kg，ARDS患者，需要严格执行保护性通气。容控下，直接设置潮气量（参考平台压<30cmH2O）。压控下，调整支持压力以达到目标潮气量（参考驱动压<15cmH2O）。
其他参数设置参考如下：
*不管吸呼比（I/E）或吸气时间（Ti），使用者设置的是呼吸机的送气时间，患者的呼气是由胸廓回弹（被动）完成。
压力支持：呼吸机送气的启动及停止，由患者“决定”，通过吸气触发及呼气触发两个参数的设置，呼吸机感知管路系统中的气流及压力变化（患者吸气做功，达到设置的触发阈值），启动及停止送气。
为保证患者的通气安全，设置后备通气。后备通气的启动，由报警设置的窒息时间决定。
个人习惯（无参考资料）：为保证分钟通气，窒息时间设置，可参考后备通气的呼吸周期时间，或预期呼吸频率的呼吸周期时间。
吸气触发：流量触发及压力触发。
*各个厂家的流量触发表示方式有可能不一样，具体的灵敏度，咨询使用的呼吸机厂家人员。并非数字小就意味灵敏度高
流量触发较压力触发灵敏。
吸气峰流速下降的变化，定义为呼气触发。
个人体会：呼吸机的参数设置主要针对四大类，ARDS的保护性通气，COPD的有效通气及预防气体馅闭，自主呼吸的人机同步性，还有最近体会特别深刻的ECMO+机械通气的闭环管理（具体可参考本公众号的其他文章哈）。
SIMV的触发窗定义，不同的品牌定义有区别。使用不同的产品应向产品的厂家了解细节。
设置窒息时间，通过后备通气保证患者的通气安全（此功能不同的厂家有区别，需要向使用的产品了解清楚哦）
APRV：别于其他通气模式，两个水平的持续压力进行切换，允许患者的自主呼吸。
通过窒息时间及后备通气，防止患者窒息，保证通气安全
以上常用模式为普博呼吸机的通气模式的参数设置。通气模式基础原理都是大差不差，但是不同厂家的参数设置细节实现会有差异，老师们还是要向厂家了解自己使用的呼吸机细节，以便更好的设置参数，实现个体化的细节哦。
普博医疗推出每月一次线上直播机械通气课程（讲者是我哈，对此篇内容有疑问的，可留言或私聊我😊）。
对第一节内容有兴趣的老师可留言“解析通气1”查阅对应内容
也可联系我哈。
对录播回放有兴趣的老师，可咨询普博销售获取链接。
对于ECMO+机械通气，有兴趣的老师，欢迎加入星球，一起分享学习ECMO-机械通气的管理。
本文来自网友投稿或网络内容，如有侵犯您的权益请联系我们删除，联系邮箱：wyl860211@qq.com 。

119页PPT | 麦肯锡:集团企业卓越采购供应链管理体系规划

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  1. CONNECT:[ UseTime:0.000497s ] mysql:host=127.0.0.1;port=3306;dbname=h_sjds;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000818s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000361s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000268s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000542s ]
  6. SELECT * FROM `set` [ RunTime:0.000222s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000570s ]
  8. SELECT * FROM `article` WHERE `id` = 477352 LIMIT 1 [ RunTime:0.000432s ]
  9. UPDATE `article` SET `lasttime` = 1775519489 WHERE `id` = 477352 [ RunTime:0.008537s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 64 LIMIT 1 [ RunTime:0.000260s ]
  11. SELECT * FROM `article` WHERE `id` < 477352 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000426s ]
  12. SELECT * FROM `article` WHERE `id` > 477352 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.001576s ]
  13. SELECT * FROM `article` WHERE `id` < 477352 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.004076s ]
  14. SELECT * FROM `article` WHERE `id` < 477352 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.002574s ]
  15. SELECT * FROM `article` WHERE `id` < 477352 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.000889s ]
0.095128s