1、q潮气量(TV):静息状态每次吸入和呼出的气量。成人400-500毫升q补吸气量(IRV):平静吸气后再吸入的气量。正常成人2500-2600毫升q吸气量(IC):平静呼气后能吸入的最大气量IC=TV+IRVq补呼气量(ERV):平静呼气后所能呼出的最大气量q残气量(RC):最大呼气后肺内残留的气量q功能残气量(FRC):平静呼气后肺内残留的气量。FRC=RC+ERV稳定肺泡气体分压,减少呼吸间歇时对肺泡内气体交换的影响可防止呼气末期肺泡将完全陷闭(动-静脉分流)FRC增加提示肺泡扩张,FRC减少说明肺泡缩小或陷闭q肺活量(VC):最大吸气后能呼出的最大气量。VC=IRV+TV+ERV。正常成
2、人4500毫升q肺总容量(TLC):深吸气后肺内所含的气量TLC=VC+RC肺容量肺容量q气管插管经口经鼻q气管切开插管插管口插管鼻插管l破伤风,感染创伤创伤l头面部 I E I EPressureVolume Spontaneous Positive Pressure I E I EResistance =PIP-PlateauPeak FlowResistance =20-151 L/sec=5 cmH20/L/secPlateau Pressure 15 cmPIP 20 cmVTE 500 ccPeak Flow=60 L/minPVC)(PEEPPVCPlatTstat)(PEEPP
3、VCPeakTdyn单位压力下容量的变化单位压力下容量的变化静态顺应性静态顺应性 动态顺应性动态顺应性 CD=30 40L/cmH2O Cs=40 60L/cmH2O 500 15-5=50 ml/cmH20Compliance =VtPlateau-PEEPPlateau Pressure 15 cmPEEP 5 cmVTE 500 ccPeak Flow=60 L/minVT 500 ml10 cmH2040PCIRCcmH2OINSPLminEXP302010 010-2080 60 40 20020-804060V.04812s2610A.PIP,B.Pplat,C.End-expir
4、atory pressurePawPResistance P=阻力 P=顺应性PEEPABC0Time(sec)压力波形症时也考虑迅速进行机械通气。减速同步间歇指令通气同步间歇指令通气 10 cm H2O PEEPTimePEEPSpontaneousMechanicalVentilationCPAP(Continuous positive airway pressure)EPAP(Expiratory positive airway pressure)CPPV(Continuous positive pressure ventilation)CPPB(Continuous positive pressure breathing)n