听说段子很搞笑
范文一：呼吸机参数
1atm ≈1bar ≈100kpa
（1）间歇正压通气（intermittent positive pressure ventilation，IPPV ）
（2）间歇正负压通气（intermittent positive negative pressure ventilation，IPNPV ）
（3）持续正压气道通气（continuous positive airway pressure，CPAP ）
一、MODE 模式
(S)CMV （Synchronized ）Control Mechanical Ventilation (同步) 控制机械通气
(A/C) MV (Assist/Control) Mechanical Ventilation (辅助/控制) 机械通气
Apnoea ventilation 窒息通气
APRV Airway Pressure Release Ventilation 压力释放通气
APV Adaptive Pressure Ventilation 适应性压力通气
ASB Assisted Spontaneous Breath 辅助自主呼吸
ASV Adaptive Support Ventilation 适应性支持通气
BACKUP 背景通气
BILEVEL Biphasic Level 双相正压通气
BIPAP Biphasic Intermittent Positive Airway Pressure 双相间歇正压（通气） BIPAP-APRV Biphasic Intermittent Positive Airway Pressure / Airway Pressure Release Ventilation 双相间歇正压（通气）-压力释放通气
BIPAP Assist Biphasic Intermittent Positive Airway Pressure Assist 辅助双相 间歇正压通气
BIPAP-SIMV Biphasic Intermittent Positive Airway Pressure/ Biphasic
Intermittent Positive Airway Pressure 双相间歇正压（通气）-同步间歇指令通气 CPAP Continuous Positive Airway Pressure 持续正压通气
CMV Control Mandatory Ventilation 控制机械通气
PLV Pressure Limited Ventilaiton 压力限制通气
IRV 反比通气
ILV Independent lung ventilation 分侧肺通气
IPPV Intermittent Positive Pressure Ventilation 间歇正压通气
MMV Mandatory minute ventilation 指令分钟通气量通气
P-CMV
Pressure---Control Mandatory Ventilation 压力目标型控制通气
P-SIMV
Pressure---Biphasic Intermittent Positive Airway Pressure 压力目标型同步间 歇指令通气
PEEP Positive expiratory end pressure 呼气末正压
PEEP/CPAP 呼气末正压
PLV Pressure Limited 压力限制通气
Vt Ventilation 潮气量
SIGH 叹息通气
SIMV Biphasic Intermittent Positive Airway Pressure 同步间歇指令通气
SPONT
压力支持通气
Intermittent 间歇
Spontaneous 自主
Assisted 辅助
机械通气常用英文索引
二，PARAMETERS 参数
%Min Vol
分钟通气量百分比
/L压力上升时间
/L压力上升时间
↑fTOT 高呼吸频率报警
air trapping
气体陷闭
apnea
窒息
ASB/L
压力上升时间
ASB 支持压力
Auto flow
自动变流
Bar Graph
条形图
Bar Graph
条形图
Basic setting
基础参数
Body Wt
病人体重
Brightness
亮度
Contrast
对比度
Error Message
出错消息
Expiratory 呼气
ETS
Expiratory trigger sensitivity
Extra setting
附加参数
fippv IPPV 频率
Flow Patter(Flow-P) 流速形式
Flow trigger
流速触发
FREEZE/UNFREEAE
对曲线冻结/解冻
f frequency
频率 呼气触发灵敏度
fTOT Total frequency 总呼吸频率
fspont Spontaneous frequency 自主呼吸频率
Hi P 高压上限
Hi Rate 高呼吸频率
Inspiration 吸气
Insp.Flow Vmax 吸气峰流速
interm.PEEP 间歇呼气末正
intrinsic PEEP 内源性PEEP 测定
Invert
反显
IPPVtrigger
压力触发
Learn Base Flow
获知基础流量
Lo Min Vent Low minute ventilation
Lo P Delay
低压报警延迟
Lo P Low pressure
低压下限
Lo Rate Low rate
低呼吸频率
Mandatory Type
指令模式
MV minute volume
分钟通气量
MONITOR
监测
O2-vol.%
氧浓度
occlution pressure 闭合压
PASB
压力支持水平
Pause/Tip
吸气相停顿时间
Pcontrol
控制通气时的吸气压力
PE END 呼气末压力
Peak Flow
吸气峰流速
PEEPI
PEEP
内源性PEEP
PEEPTOT 低每分通气
总PEEP
Phigh Plow
高/低压力
P-high/low T-high/low: BIPAP-APRV中的高-低压力/时间高/低
PI END
吸气末压力
PI
压力控制模式下的吸气压力
Pinsp Inspiration pressure
吸气压力
PIP
峰值吸气压
Pmax
压力限制
Pmean
Mean pressure 平均压
Pplat
Plat pressure 平台压
Pramp
Ramp pressure 压力上升时间
PSENS 或VSENS
压力或流速触发
Psupp
压力控制模式下的吸气压
Psupport
自主呼吸的支持压力
RAMP or SQUARE
容量控制模式下的流速波形
sign
叹息
Ramp
压力上升时间
Spontaneous Type
自主呼吸方式
System Info
系统信息
Test Alarms
测试报警
Thigh /Tlow
高/低压力时间
TI (Tinsp)
Inspiration time 吸气时间
TE Expiratory time 呼气时间
Ti/Ttot
Inspiration time /total time 吸气时间/总呼吸周期
TI:TE
Inspiration time/ Expiratory time 吸呼比
tidal volume 潮气量
TPR Time at Pressure Reset
压力复位时间
Tot.Leak Total leak 总漏气
Tp1
容量控制模式下的吸气相平台时间
TPL Plat time
平台期时间
trgger window
触发窗
trigger off
触发关闭
Trigger Type
触发模式
triggerΔPtrPPV 模式下触发灵敏度，为压力触发，可关闭
Vmax
容量控制模式下的最大吸气流速
Vtarget
Target ventilation 目标潮气量
Vt Tidal volume
潮气量
：IPPV 模式下呼吸机的工作频率SIMV ，MMV 模式下用以调节平台时间。
三ALARM SET报警设置
ALARM RESET
解除报警
ALARM SILENCE
报警静音2分钟
etCO2
呼气末CO2浓度
MVtotal
分钟通气量
Paw
Airway pressure 气道压力
tachypnoea monit.
呼吸频率过快报警
fapnoea Apnoea frequency 窒息频率
Tapnoea Apnoea tine
转化为窒息通气的时间
velume monitoring
潮气量报警
volume warning
容量报警
VTi
吸入潮气量
四特殊监测
DSENS 呼吸机管路与患者脱离报警限
Intrinsic PEEP 内源性PEEP
Loop 环
Vtrap 陷闭容量
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范文二：呼吸机参数
【摘要】 呼吸机已经成为常规医疗装备，被普遍应用于临床科室的急救和重症监。本文就呼吸机使用和维修中经常遇到的问题提出看法和建议，以使操作及工程技术人员，尤其是新接触呼吸机的人员，对基本原理、性能参数、使用特点和病人与仪器之间的相互作用等基本知识有个比较全面的了解，以便更好地发挥呼吸机的效能和使用效率。
【关键词】 呼吸机；参数设置；故障处理
一、呼吸机的结构
呼吸机一般分为：常频呼吸机（成人10~60次）、高频呼吸机（成人＞60次）和体外模肺。其中，常频呼吸机又包括：正压呼吸机和负压呼吸机，医院最常用的是气道内正压呼吸机。一个完善的呼吸机由供气装置、控制装置和病人气路三部分构成。
1. 供气装置
由空气压缩机（提供高压空气）、氧气供给装置或氧气瓶（提供高压氧气）和空氧混合器组成。主要提供给病人吸入的氧浓度在21%~100%的高含氧气体。
2. 控制装置
由计算机对设置参数及实测值进行智能化处理，通过控制器发出不同指令来控制各传感器、呼出阀、吸气阀来满足病人呼吸的要求。
3. 病人气路
由气体管道、湿化器、过滤器等组成。
二、呼吸机参数选择及设置
在呼吸机的使用操作中，首先需要选择和设置许多参数，非临床的工程人员和临床医务人员一样，要了解基本参数的含义、要求、范围等。
1. 呼吸模式选择
在呼吸机的操作中，首先要选择病人呼吸模式，现代机型最常用的有三种模式：
（1）A/C（辅助/控制通气）：病人有自主呼吸时，机械随呼吸启动，一旦自发呼吸在一定时间内不发生时，机械通气自动由辅助转为控制型通气。它属于间歇正压通气。
（2）SIMV （同步间歇指令性通气）：呼吸机于一定的间歇时间接收自主呼吸导致气道内负压信号，同步送出气流，间歇进行辅助通气。
（3）SPONT （自主呼吸）：呼吸机的工作由病人自主呼吸来控制。
在以上三种基本模式下，各类呼吸机还都设计了针对各种疾病的呼吸功能，供使用时选择。例如：
（a ）PEEP （呼吸终末正压）：在机械通气基础上，于呼气末期对气道施加一个阻力，使气道内压力维持在一定水平的方式。
（b ）CPAP （持续气道内正压通气）：在自主呼吸的前提下，整个呼吸周期内人为地施以一定程度的气道内正压，可防止气道内萎陷。
（c ）PSV （压力支持）：在自主呼吸的条件下，每次吸气都接受一定程度的压力支持。 （d ）MMV （预定的每分钟通气量）：如果SPONT 的每分钟通气量低于限定量，不足的气量由呼吸机供给；SPONT 的每分钟通气量大于限定量，呼吸机则自动停止供气。
（e ）BIPAP （双水平气道内正压）：病人在不同高低的正压水平自主呼吸，可视为PSV ＋CPAP ＋PEEP 。
（f ）APRV （气道压力释放通气）：在CPAP 状态下开放低压活瓣暂时放气，降低气道压力而形成的通气。
2. 通气方式选择
在选择好呼吸模式后，就要选择或要知道通气方式：
（1）容量控制通气（VCV ）：设定一个潮气量，由流量×吸气时间来调节。
（2）压力控制通气（PCV ）：设定一个压力，它是由吸气平台压决定。
3. 触发方式选择
（1）压力触发：当管道内的压力达到一定的限值时，呼吸即切换。
（2）流量触发：当管道内的流速变化到一定值时，呼吸即切换。由于其灵敏度高、后滞时间短，已被广泛应用。
（3）时间切换：由时间来控制，设定的时间一到，呼吸即切换。
4. 报警参数选择
呼吸机的各种参数的设置是相互关联的，所以我们要知道各种设置的基本含义和正常值范围，才能准确地设置报警参数。成人应用呼吸机的生理指标为：潮气量5～7ml/kg；呼吸频率12～20次/分；气道压30～35cmH2O ；每分钟通气量6～10l/min。
在呼吸机使用中，报警上下限的设置也非常重要。如果报警设置与病人实际值太接近，就会造成呼吸机经常性的报警；而如果报警设置范围太大，就会失去报警意义。因机型的不同，报警的设置也各不一样，但一般都应有：
（1）管道压力上下限报警。
（2）潮气量上下限报警。
（3）呼吸暂停间隔时间报警。
（4）分钟通气量上下限报警。
（5）呼吸频率上下限报警。
以上呼吸机在操作中需要选择和设置的基本参数，是各类呼吸机所共有的。各种品牌的呼吸机都是在此基础上再开发一些新的功能，而这些功能主要是针对临床使用的，对于工程技术人员来说，充分了解呼吸机的基本工作原理、各种设置的含义和范围，就能掌握基本操作，这对于呼吸机维修也是非常重要的。
三、呼吸机的常见故障与处理
在呼吸机的维修过程中，首先要查看是否有报警提示，如有，则须以排除报警为前提。要本着先易后难的原则，从最简单开始入手检查。现根据不同类型的呼吸机常见的故障进行总结分析。
1. 空压机故障
（1）空压机不工作：电源未接通或过热保护。
（2）压力不够：过滤器堵塞、内部管道漏气、压力调节过低、泵膜或活塞环损坏。
（3）噪音过大：减震垫损坏或弹簧变形。
2. 氧浓度与实测值差异过大
（1）氧电池失效：更换氧电池或关闭此功能。
（2）空氧混合器损坏：检修或更换。
3. 呼吸机不能正常启动
（1）电源故障：检修保险丝及电源。
（2）气源故障：检查两种气源压力。
（3）主机故障：检修主机电路。
4. 连接模拟肺，面板报警区始终有报警
（1）检查病人管路及湿化器是否有漏气、积水。
（2）检查相应的设置参数及报警参数。
（3）检查清洁各传感器及电磁阀。
（4）检查控制电路。
5. 呼吸机保养及消毒
各类呼吸机都有专门手册介绍，只要按照要求认真做好保养与消毒，可延长主机和各附件的使用寿命，并可降低故障率。
范文三：无创呼吸机参数
无创呼吸机技术参数
购买要求 原装进口
通气类型 无创正压通气NPPV 认证资质 具备CE和FEA认证资质 工作模式 S、T、ST、CPAP 存储 便携式存储，能随时记录治疗信息
参数设置
IPAP 4----28cmHO 2
EPAP 4----22cmHO 2
CPAP 4----20cmHO 2
呼吸频率 0-30次/分
最大吸气时间 0.5—3s
最大气流流量 240L/min
触发方式 自动触发
电源要求 AC100-240V，50-60Hz 压力上升时间 0.1-0.6s可调
监测参数
呼出潮气量
分钟通气量
漏气量
呼吸频率、吸呼比 持续气道正压 具备
报警参数
窒息时间
面罩脱落报警
漏气报警
断电、漏电报警
机器故障报警
低分钟通气量报警 售后保修 保修3年，提供相关的技术支持
范文四：呼吸机使用参数
呼吸机使用参数
A ventilator setting and regulation 1, respiratory frequency: 8-18 / min, is generally 12 / min.. Exceptions to COPD and ARDS. 2, tidal volume: 8-15ml/kg weight, according to clinical and blood gas analysis of the results of appropriate adjustments. 3, inspiratory / expiratory ratio: inspiratory time will generally be set at 1, inspiratory / expiratory ratio should be 1:2-2.5, restriction for 1:1-1.5 disease, cardiac insufficiency is 1:1.5, ARDS is suitable for 1.5-2:1 (it is inversely proportional to breathing, expiratory time is 1). 4 inspiratory flow rate (Flow): adults generally 30-70ml/min. Quiet, sleep can reduce the flow rate; fever, irritability, convulsions and other circumstances, to improve the flow rate. 5, inhalation oxygen concentration (FiO2): long time oxygen generally not more than 50%-60%. 6, trigger sensitivity adjustment: usually 0.098-0.294kPa (1-3cmH2O), according to the patient's own inspiratory force size adjustment. The traffic trigger is 3-6L/min. 7, inspiratory pause time: General 0-0.6s, not more than 1s. 8, PEEP regulation: when FiO2>60%, PaO2<8.00kpa (60cmh2o)="" should="" add="" peep.="" clinically,="" the="" peep="" value="" is="" usually="" 0.29-1.18kpa="" (3-12="" cmh2o),="" rarely="" more="" than="" 1.47kpa="" (15="" cmh2o).9,="" and="" the="" alarm="" parameters="" are="" adjusted:="" different="" ventilator="" alarm="" parameters="" are="" different,="" according="" to="" the="" principle="" of="" both="" safe="" and="" quiet.="" pressure="" alarm:="" mainly="" used="" for="" monitoring="" of="" the="" patient's="" airway="" pressure,="" under="" normal="" circumstances,="" the="" high-pressure="" limit="" is="" set="" in="" the="" normal="" airway="" pressure="" (peak="" pressure)="" on="" 0.49-0.98="" kpa="" (5-10="" cmh2o),="" low="" voltage="" limit="" set="" the="" minimum="" pressure="" level="" can="" keep="" breathing.="" fio2:="" 10%-20%.="" tidal="" volume="" can="" be="" higher="" or="" lower="" than="" the="" actual="" set="" of="" fio2:="" high="" level="" alarm="" setting="" is="" the="" same="" as="" that="" set="" by="" tv="" and="" mv;="" low="" level="" alarm="" limit="">
maintain the minimum TV and MV level of patient's life. PEEP or CPAP alarm: general use of PEEP or CPAP level prevail. Two, all kinds of alarm ventilator and the significance of treatment 1, airway pressure (1): high airway pressure: Patients with airway obstruction (due to respiratory resistance), tracheal intubation too deep insertion of right bronchial trachea, tracheal cannula slides into the subcutaneous, man-machine confrontation, cough, lung compliance (low ARDS, pulmonary edema, pulmonary fibrosis), restrictive ventilatory disorder (abdominal distension, pneumothorax, mediastinal emphysema, pleural effusion) (2): respiratory sounds auscultation exists asymmetry, phlegm sound, breathing is low; sputum suction; sternum exclude anomalies; check the position of trachea cannula; check the pipeline patency; adjust ventilator synchrony; use decreasing ventilator synchrony; using decreasing flow velocity waveform; by pressure control mode; bronchodilator; sedation. 2, the Low airway pressure reason: low airway pressure pipeline leakage, slide out, intubation ventilator settings improper treatment: check the leak; increase the peak velocity or pressure control mode; such as spontaneous breathing, modified PSV model; increase tidal volume; adjust the alarm settings. 3, Low tidal volume (low tidal volume ventilation deficiency): (1) * low inspiratory tidal volume: tidal volume is set too low, alarm set too high, spontaneous breathing mode patient suction strength is weak, improper, gas sensor fault mode. * low expiratory tidal volume: the pipe leaks and the rest is the same as above.
(2): check the pipeline to determine whether leakage; if the patient inhale lack of strength can increase the pressure of PSV or modified A/C model; according to the patient's weight
setting the alarm range; with simulated lung ventilator aspirated; tidal volume aspirated table monitoring to determine ventilator tidal volume sensor is accurate with tidal volume. 4, low Low minute volume (minute ventilation hypoventilation) (1): tidal volume ventilation is set too low, the frequency is set too low, the alarm is set too high, spontaneous breathing mode with inadequate ventilation, pipeline leak. (2) treatment: exclude the pipeline leakage; increase the auxiliary ventilation parameters; such as spontaneous breathing rate is not fast; can use MMV mode and set appropriate ventilation per minute; appropriate adjustment alarm range. 5, high minute ventilation volume, High, minute, volume (hyperventilation) (1): the patient was nervous, irritable, severe hypoxia, ventilator ventilation parameters were too high, the ventilator mistakenly triggered, resulting in high ventilatory frequency. (2): the machine can be used to exclude treatment causes muscle relaxant or sedative excessive ventilation to prevent patients; improve the patient's oxygenation, increase oxygen concentration or with PEEP; reasonable adjustment of ventilation parameters; if false triggering can reduce the trigger sensitivity, closed flow trigger, check whether the leak valve. 6, I:E (1) is inverse respiratory reasons: Inspiration for too long (aspirated low velocity and tidal volume is too large, high airway resistance), expiratory time is too short, the respiratory frequency is too high. (2) increase the inspiratory flow rate; reduce the inspiratory time of the pressure control mode; improve the airway patency; reduce the respiratory rate; if required inverse ventilation, can be closed inverse ratio ventilation alarm. 7, asphyxia (1) reason: the patient's spontaneous breathing is too weak, the patient appears apnea, airway leak.
(2) treatment: increase trigger sensitivity, increase ventilation frequency; change A/C or SIMV mode; check airway leak. 8, the ventilator work exception handling: immediately from the patient with respiratory bladder transition; with lung ventilator can be aspirated, shut down the machine again open, observe whether the fault still exists; do the machine self test to determine the cause of the malfunction; in principle, failure may be a breathing machine can not be used for patients with mechanical ventilation; inform the maintenance engineer. Four, 1. commonly used intermittent positive pressure breathing (intermittent positive pressure ventilation, IPPV): the basic way of ventilation. Positive pressure is generated during breathing, and the gas is pressed into the lungs and exhaled by the body's own pressure. 2. breath platform (plateau): also called the end inspiratory positive pressure breathing (end inspiratory positive pressure breathing, EIPPB), inspiratory, expiratory, exhalation valve to shut down for a period of time, and then open the breath, this time is generally not more than 5% of the respiratory cycle, can reduce the VD/ VT (dead space / tidal volume 3.) positive end expiratory pressure (positive end expiratory pressure, PEEP): in the premise of intermittent positive pressure ventilation, keep a certain end expiratory airway pressure, in the treatment of respiratory distress syndrome, non cardiogenic pulmonary edema and pulmonary hemorrhage play an important role. 4. intermittent mandatory ventilation (intermittent, mandatory, ventilation),
IMV), SIMV (synchronized intermittent mandatory ventilation, SIMV), belongs to the field of ventilation, a continuous flow of air ventilation pipe, (self breathing) several times after
a spontaneous breathing to ensure positive pressure ventilation, minute ventilation, respiratory frequency Chengren IMV is generally less than 10 beats per minute, for normal children the frequency of the 1/2~1/105. expiratory delay, also called lag expiratory (expiratory retard): mainly used for early airway collapse and chronic obstructive pulmonary diseases, such as asthma, application time should not be too long. 6. take a deep breath or sigh (sigh) 7. stress support (pressure, support): on the basis of voluntary breathing, provide a certain amount of pressure support, so that each breath pressure can reach the peak pressure value. 8. continue positive pressure (CPAP): in addition to regulating the CPAP knob, it is necessary to ensure adequate flow, flow should be increased by 3~4 times airway. CPAP normal values generally 4~12cm water column, under special circumstances up to 15 cm water column. (expiratory pressure 4 cm water column). The connection between the ventilator and the human body: the condition is urgent, or the estimated intubation retention time will not be too long, the neonates, premature infants, and general mouth intubation. In other cases, you may have a nasal cannula or an incision through the trachea. Six, ventilator parameters adjustment: four major parameters: tidal volume, pressure, flow rate, time (including respiratory rate, suction call ratio). 1. tidal volume: normal tidal volume tidal output must be greater than the physiological tidal volume of 6~10 ml / kg, while the ventilator output can reach 10~15 moisture ml / kg, often is 1~2 times of physiological tidal volume. According to the ups and downs, two lung chest auscultation, reference pressure, intake. Blood gas analysis further adjustment. 2. suction frequency: close to the physiological respiratory rate. The newborn baby 30~40 / min, 40~50 / min,
older children 20~30 / min, chengren16~20 / min. Tidal volume * respiratory rate = per minute ventilation volume 3. inspiratory call ratio: General 1:1.5~2, obstructive ventilatory disorder can be adjusted to 1:3 or longer expiratory time, restrictive ventilatory disorder can be adjusted to 1:1. 4. pressure: generally refers to the peak airway pressure (PIP), when the normal lung compliance, peak inspiratory pressure is generally 10~20 cmH2O, mild pulmonary lesions: 20~25 cm water column; moderate: 25~30 mm of water; severe: 30 cm above the water column, RDS, pulmonary hemorrhage up to 60 cm above the water column. But generally less than 30, newborns lower than the pressure of 5 cm water column. 5. PEEP IPPV children to PEEP2~3 cm water column is in line with the general physical condition, when the serious disturbance of ventilation when (RDS, pulmonary edema and pulmonary hemorrhage) need to increase PEEP, usually in the 4~10 cm water column, in severe cases, up to 15 or even 20 cm above the water column. When the concentration of oxygen exceeds 60% (FiO2 is greater than 0.6), such as arterial partial pressure of oxygen is still below 80 mmHg, PEEP should be increased mainly until the arterial partial pressure of oxygen exceeds 80 mmhg. PEEP each increase or decrease 1~2 mm water column, will have a great impact on blood oxygen, this effect can occur within minutes, reduce PEEP should be gradually carried out, and pay attention to monitoring changes in blood oxygen.
PEEP can be read out from the surface pressure numerical pointer end expiratory position. (special display better): at least two times the flow rate of 6. per minute ventilation volume, 4~10 L / min. Further, according to the regulation of seven blood gas analysis: first to check whether the respiratory tract
unobstructed, tracheal catheter position, two lung intake is good, whether it is normal, there is no ventilator air leak. Adjustment method: 1. PaO2 is too low: (1) increasing oxygen concentration (2), increasing PEEP value (3), such as insufficient ventilation, can increase the volume of ventilation per minute, extend the inspiratory time, inspiratory end stay, etc.. 2., PaO2 is too high: (1) reduce the oxygen concentration (2) gradually reduce the PEEP value. 3., PaCO2 is too high: (1) increase the respiratory rate (2), increase tidal volume: fixed volume type can be adjusted directly, fixed pressure type, increase the preset pressure, timing increase flow and improve pressure limit. 4. PaCO2 is too low: (1) slow down the breathing rate. Can prolong expiratory and inspiratory time at the same time, but should lengthen expiratory time to give priority to, otherwise it will be opposite action. Change to IMV if necessary. (2) reduction of tidal volume constant volume type can be adjusted directly, the constant pressure type can reduce the preset pressure, timing can reduce the flow and reduce the pressure limit. Eight, humidification: warming humidification: best tank water temperature 50~70 degrees Celsius, the standard length of 1.25 meters, the outlet gas temperature of 30~35 degrees Celsius, humidity 98~99%. Only the distilled water can be used. Atomizer: low temperature and high irritation. Patients are more difficult to accept. Direct intratracheal drip: especially airway sputum obstruction, drip after repeated backslapping, sputum aspiration, often can relieve bad ventilation. Specific methods: adults every 20~40 minutes instillation of 0.45~0.9 saline 2 ml, or 4~6 drops / minute rate drops, the total amount of more than 200 ml / day children every 20~30 minutes 3~10 drops, the airway secretions thin, smooth, no sputum should attract.
Artificial nose. Slightly. Nine, oxygen concentration (FiO2): general machine oxygen concentration adjustable from 21~100%. It is necessary to correct hypoxemia and prevent oxygen poisoning. Generally should not exceed 0.5~0.6, such as more than 0.6 hours should be less than 24 hours. Objective: to make arterial blood PaO2 greater than 60 mm Hg (8.0Kpa) at the lowest oxygen concentration. As for oxygen can relieve cyanosis can be added with PEEP. 1 oxygen can be used during resuscitation without regard to oxygen intoxication. Ten, set alarm range: air pressure, upper and lower limit alarm (usually set value of 30%), air pressure alarm, other alarm. Eleven, accidental problem: ventilator should be equipped with a recovery device, or other simple artificial air sac, the connection between air sac and endotracheal tube should also be prepared. Attention to avoid pipe, pipe, ventilator failure, gas source and power failure. Twelve, common complications: pressure injuries, circulatory disorders, respiratory tract infections, atelectasis, laryngeal and tracheal injuries. Thirteen, the weaning: gradually reduce the oxygen concentration, PEEP gradually reduced to 3~4 cmH2O, IPPV to IMV (or SIMV) or pressure support, gradually reduce IMV or support pressure, the final transition to CPAP or complete withdrawal of the ventilator, the entire process takes a close observation of the respiration, blood gas analysis. Extubation indications: strong breathing and cough, good swallowing function, the result of blood gas analysis is normal, no throat obstruction, extubation can be considered.
A pull out tracheal intubation, tracheotomy can change through tubes, tube plugging, plugging half order, gradually pulling the set tidal volume ventilation tidal volume parameter setting,
a ventilator setting of mechanical ventilation is the first issue to be considered. In volume control ventilation, the goal of tidal volume setting is to ensure adequate ventilation and make the patient comfortable. Chengren tidal volume is generally 5 ~ 15ml/kg, 8 ~ 12mg/kg is the most commonly used range. The amount of tidal volume should be considered as follows: chest lung compliance, airway resistance, compressed volume of ventilator tubes, oxygenation, ventilatory function, and risk of air pressure. The ventilator related injuries are caused by improper use of mechanical ventilation. During the tidal volume setting, the pressure of the airway platform should not exceed 35 ~ 40cmH2O in order to prevent the occurrence of air pressure injury. For pressure controlled ventilation, tidal volume is mainly determined by preset pressure levels, patient inspiratory strength, and airway resistance. In general, tidal volume levels should not be higher than 8 to 12ml/kg. Mechanical ventilation frequency, two mechanical ventilation frequency set ventilator should consider the ventilation mode, tidal volume size, dead cavity rate, metabolic rate, PaCO2 target level and patients' respiratory function and other factors. For Chengren, mechanical ventilation frequency can be set to 8 to 20 times per minute. For patients with acute and chronic restricted ventilation dysfunction, mechanical ventilation should be set high frequency (20 beats per minute or more). After 15~30 minutes of mechanical ventilation, according to arterial partial pressure of oxygen, partial pressure of carbon dioxide and pH value, into one to adjust the frequency of mechanical ventilation. In addition, the frequency of mechanical ventilation should not be set too fast to avoid the closure of pulmonary gas and the generation of endogenous positive end
expiratory pressure. Once endogenous positive end expiratory pressure is produced, it affects lung ventilation / blood flow, increases respiratory function, and increases the risk of air pressure injury. Three ventilator ventilation flow rate settings, many ventilators need to set the inspiratory flow rate. The suction flow rate setting should pay attention to the following issues: 1. / volume control ventilation, such as patients with no spontaneous breathing, then the suction flow rate should be less than 40 liters / min; for patients with spontaneous breathing, inspiratory flow rate is the ideal should be just to meet the needs of patients with peak inspiratory flow. The inspiratory flow rate is generally adjusted to 40~100 L / min depending on the patient's inspiratory strength and minute ventilation. The magnitude of the inspiratory flow rate will directly affect the patient's breathing work and man-machine coordination, and should be paid attention to by clinicians. 2. when pressure controlled ventilation, the peak inspiratory flow rate is determined by the preset pressure level and the patient's inspiratory strength, and the maximum inspiratory flow rate is limited by the performance of the ventilator. Four. The setting of ventilator suction ratio and the ratio of ventilator to ventilator in mechanical ventilation should take into account the influence of mechanical ventilation on hemodynamics, oxygenation status and the level of spontaneous breathing. 1. spontaneous breathing with ventilator assisted breathing, ventilation should be fitted with the patient aspirated inspiratory phase, to ensure that both the synchronous. General inspiratory need 0.8 ~ 1.2 seconds, suction call ratio is 1: 2~1: 1.5. 2. for the control of ventilation patients, general inspiratory time longer, high suction call, can improve the
average airway pressure, improve oxygenation. But extended inspiratory time,
Attention should be paid to monitoring hemodynamic changes in patients. 3. inspiratory time is too long, the patient is not easy to bear, often need to use tranquilizer, even muscle relaxant. Moreover, the short expiratory time can cause an endogenous positive end expiratory pressure and aggravate disturbance to the circulation. Attention should be paid to clinical application. Five, ventilator airflow mode settings, many ventilators have a variety of airflow patterns to choose from. The common air flow patterns include decelerating airflow, accelerating air flow, Fang Bo air flow and sine wave air flow. The choice of airflow mode is only applicable to capacity control ventilation mode. In the pressure control ventilation, the ventilator provides deceleration airflow, so that the airway pressure rapidly reaches the set pressure level. Volume control ventilation, comparative study on airflow pattern less, from the existing data, when the tidal volume and inspiratory time / breathing time under the same effect of airflow patterns of patients with ventilation and respiratory function were similar. Of course, the volume controlled ventilation is used to set the airflow pattern on the square wave current. The effect of different airflow patterns on patients should be further studied and observed. Six, mechanical ventilation ventilator settings inhaled oxygen concentration, oxygen concentration of the suction ventilator settings generally depends on the arterial oxygen pressure target level, positive end expiratory pressure and mean airway pressure and hemodynamics in patients with state. Because the inhalation of high concentration oxygen can produce oxygen toxic lung injury,
the general requirement of oxygen concentration is below 50% ~ 60%. However, in the selection of the oxygen concentration, not only the lung injury of high oxygen concentration should be taken into account, but also the lung damage caused by excessive airway pressure and alveolar pressure should be considered. For patients with severe aerobic disturbance, the oxygen concentration should be set up under the premise of sufficient sedation and proper end expiratory positive pressure to make the arterial oxygen saturation > 88% ~ 90%. Seven 、 ventilator trigger sensitivity settings, at present, the ventilator suction trigger mechanism has two kinds of pressure triggering and flow triggering. Because the ventilator and the artificial airway can produce additional resistance, the trigger sensitivity should be set at a sensitive level in order to reduce the additional work done by the patient. Normally, the triggering sensitivity of pressure triggering is set at -0.5 ~ -1.5cmH20, while the sensitivity of flow triggering is set at 1~3 L / min.. According to preliminary clinical studies, the use of flow triggering can further reduce the patient's breathing work and make patients more comfortable compared to stress triggers. It is worth noting that when the trigger sensitivity setting is too sensitive, small changes in pressure and flow in the airways can trigger automatic triggering, which can make the patient uncomfortable. Eight. The positive end expiratory pressure (PEEP) is used to increase lung volume, increase airway pressure and improve oxygenation. In addition, the positive end expiratory pressure can also cancel the intrinsic positive end expiratory pressure, and decrease the inspiratory triggering work caused by the endogenous positive end expiratory pressure. But the positive end expiratory pressure can cause an increase
in intrathoracic pressure, resulting in a decrease in venous return and a decrease in left anterior cardiac load. The positive end expiratory pressure should be chosen
theoretically, that is, to obtain the positive end expiratory pressure of maximal oxygen delivery, which is difficult to be used clinically. For ARDS patients,
The choice of positive end expiratory pressure should be combined with inhaled oxygen concentration, inspiratory time, arterial oxygen partial pressure level and target level, oxygen transport level and other factors. The development of pulmonary mechanics monitoring (pressure volume loop) makes it possible to select the positive end expiratory pressure. It is generally believed that the positive end expiratory pressure level should be slightly higher than the pressure level at the low pressure loop of lung pressure volume in the early stage of acute lung injury. For patients undergoing thoracic or upper abdominal surgery, 3 to 5cmH20 positive end expiratory pressure during mechanical ventilation is helpful to prevent postoperative atelectasis and hypoxemia. Nine. The monitoring and alarm setting of the ventilator airway pressure, the ventilator monitors the airway pressure through different parts, the basic purpose is to monitor the alveolar pressure. The common sites of pressure measurement include the ventilator, Y tube and carina. The farther away the pressure place is from the alveoli, the greater the difference between measured pressure and alveolar pressure. When the patient inhales the trigger when ventilator pressure, Y pipe pressure, pressure and pressure decreased alveolar carina, and when the pressure in the ventilator aspirate, ventilator, Y pipe pressure, pressure and pressure increased alveolar carina. Only when the air flow rate
is zero, the pressure in each part is the same. The pressure field of the 900C ventilator is in the ventilator, while the Newport and Drag ventilator are located at the Y tube. Including monitoring ventilator on airway pressure: 1. peak pressure peak pressure is the maximum pressure in the process of air ventilator. In volume controlled ventilation, the peak pressure depends on lung compliance, airway resistance, tidal volume, peak flow rate, and airflow patterns. When pulmonary compliance is similar to airway resistance, the higher the peak flow rate, the higher the peak pressure. In general, when other parameters are the same, the peak pressure in the accelerated flow is higher than that in the other airflow modes. In pressure controlled ventilation, the peak airway pressure level is close to the preset pressure level. However, due to pressure control as the deceleration airflow, the early suction to achieve the preset pressure level; the ventilator provides a high gas flow rate, the airway pressure may be slightly higher than the preset level 1 ~ 3cmH20. 2. the pressure of the platform pressure platform is the airway pressure at the end of the inspiratory air holding for 0.5 seconds (both the inspiratory and expiratory valves are closed and the airflow is zero), which is close to the peak pressure of the alveolar. Pressure control ventilation, such as the last 0.5 seconds of air flow rate as an image, the default pressure is platform pressure. 3. mean pressure and mean pressure are the mean airway pressure during the whole respiratory cycle, which can indirectly reflect mean alveolar pressure. Since expiratory resistance is higher than inspiratory resistance, the mean airway pressure is often lower than the mean alveolar pressure. 4. the end expiratory pressure, the end expiratory pressure is the pressure at the end of the exhalation, equal to the barometric or positive end expiratory
pressure. When inspiratory duration and expiration were shortened, the positive end expiratory pressure remained positive, resulting in endogenous end expiratory pressure, where the airway pressure at the end of the breath was different from that of alveolar pressure. Therefore, the airway pressure at the end of inspiration is higher than that in the alveoli, which is related to the resistance of the airway to the airflow, while at the end of the breath, such as the airway pressure is lower than the alveolar pressure, it is related to the endogenous positive end expiratory pressure. Clinicians should pay attention to.
范文五：有创呼吸机参数
有创呼吸机参数
一、数量:2 台
二、产地:原装进口～国际一线品牌～市场占有率高。 三、用途:适合成人、儿童使用～有创无创通气兼备。 四、技术参数
,一,工作模式
1.1 辅助间歇正压通气IPPVAssist,A/C,。
1.2 同步间歇指令通气,SIMV, 。
1.3 双相气道正压通气,BIPAP/BiVent/Bi-Level)
1.4 CPAP/SPONT 持续气道正压/自主呼吸。
1.5 无创通气,NIV,:可以应用于辅助/控制,A/C,～同步间歇指
令通气,SIMV,～自主呼吸Spont 。
1.6 容量目标双模式,PRVC/VV+,:具备目标容量压力控制模式
,VC,和目标容量压力支持,VS,。
1.7 插管补偿功能,ATC,:补偿率从0，100%可调,可在所有通气
模式下使用,。
* 1.8 特殊通气模式:ASV或PAV+或MMV(标配)。
* 1.9 采用中心供气或空气压缩机方式,空气压缩机 标配,。 ,二,设置参数
2.1 通气频率:1，100/分。
2.2 吸气时间:0.2 ，8秒。
2.3 潮气量:25，2000毫升。
2.4 吸气流速:1，180升/分。
2.5 吸入氧浓度:21-100%。
2.6 平台时间,即吸气后屏气) :0，2秒。
2.7 PEEP:0，35厘米水柱。
2.8 流速触发灵敏度:0.2，20升/分。
2.9 压力触发灵敏度:低于PEEP0.1，20cmHO。 2
2.10 压力支持:0，70 cmHO。 2
2.11 压力上升梯度:1，100%可调。
2.12 漏气补偿:0，60升/分。
2.13 容量控制通气,VCV,时～可选择方波和减速波。 2.14 呼气灵敏度:5，55%可调。
,三,性能参数
* 3.1 具备?15寸以上全彩色TFT触摸屏显示和操作～屏幕可与
主机分离～中文操作软件～能用不同颜色区分吸、呼气相和自
主呼吸波形～方便临床应用～在进行设置参数时不影响病人监
测参数及波形图的显示。
3.2阀门反应时间,0.5ms～病人的吸气作功, 20cmH2O×ms
3.3 采用内置超声或晶体热膜式流量传感器,如外置或传染器需要
更换～保证随时免费更换,。
3.4 呼出阀可消毒～如呼出阀不可消毒～需配细菌过滤器,按每台
每年各备5年的用量,。
3.5 具备?60分钟后备电源。
,四,监测参数
4.1 气道压力:峰压～平均压～PEEP～平台压。
4.2 氧浓度:吸入氧浓度。
4.3 分钟通气量:分钟通气量～自主呼吸分钟通气量。 4.4 潮气量:吸入潮气量～呼出潮气量～自主呼出潮气量。 4.5 频率:自主呼吸频率～指令呼吸频率。
4.6 特殊参数:顺应性,C,、气道阻力,R,、 内源性PEEP,PEEPi,、
VC,肺活 量,、呼气末流量 (EEF)、自主呼吸峰流量 (PSF)、
呼气峰流量 (PEF)、闭合压,P0.1,、吸气负压,NIF,、浅快
呼吸指数,RSB,。
4.7 曲线:压力～流量～容量。
4.8 呼吸环:压力容量环～流速-容量环。
4.9 曲线:压力～流量～容量。
4.10 可以监测存储50种以上参数的72小时趋势图和数据。 ,五,报警:
* 5.1 声、光、色三级智能报警～要提供报警信息内容～同时提供
报警解决方案。
5.2 断电报警。
5.3 高压:7，100cmH2O。
5.4 管道脱落报警:0，95%。
5.5 窒息报警时间:20，60s。
5.6 高呼出分钟通气量:0.1，99.0L/min或关。
5.7 高呼出潮气量:50，3000ml或关。
5.8 高呼出频率:10，110/min或关。
5.9 自发,机械,低呼出潮气量:5，2500ml或关。 5.10 低呼出分钟通气量:0.01，60L。
备注:
1、免费保修2年～保修期后只收维修配件费,
2、经销商在兰州有长期售后服务人员,
3、标注*的为关键性技术参数～若投标参数与该项要求出现负偏离
将导致废标。
