重症监护常规通气的当前模式

Edwards Steve M , Matthews Peter C
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引用次数: 2

摘要

在实践中,危重患者的通气应按以下方式建立:•设定一个足以保持肺泡开放的PEEP水平(高于下拐点;图3)•确保最大吸气压力不超过30 cmH2O(上转折点),即使这会导致小潮气量和允许的高血氧症•确保呼气时间足够防止气体捕获和内在PEEP,通过检查呼气末流量在波形上恢复为零•设置吸入氧气时接受60 mmHg (8 kPa)的PaO2。
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Current modes of conventional ventilation in intensive care

In practical terms, ventilation of critically ill patients should be established in the following way:

• Setting a level of PEEP that is adequate to keep the alveoli open (above the lower inflection point; Fig. 3)

• Ensuring that the maximum inspiratory pressure does not exceed 30 cmH2O (the upper inflection point), even if this results in small tidal volumes and permissive hypercapnia

• Ensuring that expiratory time is adequate to prevent gas trapping and intrinsic PEEP, by checking that the end‐expiratory flow returns to zero on the waveforms

• Accepting a PaO2 of 60 mmHg (8 kPa) when setting inspired oxygen.

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