Elisee50中文操作培訓(xùn)

1、waking people up to sleep resmedelise產(chǎn)品特點產(chǎn)品特點卓越性能源于科技卓越性能源于科技 resmed患者適用范圍患者適用范圍 icu / ccu 呼吸機(jī)呼吸機(jī) 壓力壓力 & 容量控制呼吸機(jī)容量控制呼吸機(jī) 有創(chuàng)有創(chuàng) & 無創(chuàng)呼吸機(jī)無創(chuàng)呼吸機(jī) 單單 & 雙呼吸回路系統(tǒng)雙呼吸回路系統(tǒng) 成人成人 & 兒童呼吸機(jī)兒童呼吸機(jī) （適合體重5 kg以上兒童、呼吸回路直徑 15 毫米、最低容量控制通氣時潮氣量 : 50 ml、最大呼吸頻率 : 80 次 / 分） resmed 簡潔直觀操作的界面簡潔直觀操作的界面l 無需任何按鈕-全觸摸式操作l

2、 圖形文字對照-極易操作使用l 通氣程序預(yù)設(shè)-快速啟動l 具備模式、參數(shù)、報警、監(jiān)測各自獨立的設(shè)定頁面。 resmed 整體化氣路結(jié)構(gòu)整體化氣路結(jié)構(gòu)堅固的整體、一體化的氣路結(jié)構(gòu)-堅固耐用，故障率低-緊湊的氣路機(jī)械死腔最小，反應(yīng)最快，呼吸同步性更好-氣路系統(tǒng)的順應(yīng)性更小，呼吸機(jī)的壓力/流量/容量輸出更精確-一體化設(shè)計融合了當(dāng)今工業(yè)設(shè)計、制造和工藝最新技術(shù) resmed超強的供氣能力超強的供氣能力第三代航空智能渦輪供氣系統(tǒng)第三代航空智能渦輪供氣系統(tǒng) -超長使用壽命 -超強供氣流速，在60厘米水柱時最高供氣流速可達(dá)300升/分。 -體積小、噪音低、慣性及功耗極低 -能夠瞬間準(zhǔn)確調(diào)節(jié)供氣流速，與患者自

3、主呼吸匹配，最大程度縮短吸氣及呼氣的反應(yīng)時間。成比例三項主動呼氣閥技術(shù)成比例三項主動呼氣閥技術(shù) resmed“人機(jī)協(xié)調(diào)性人機(jī)協(xié)調(diào)性”觸發(fā)技術(shù)觸發(fā)技術(shù) 具備三種觸發(fā)判斷方式：具備三種觸發(fā)判斷方式：壓力、流速、能量轉(zhuǎn)移，先進(jìn)的吸氣觸發(fā)技術(shù)，保證了優(yōu)異的人機(jī)同步性/協(xié)調(diào)性，降低了病人的吸氣做功 吸氣觸發(fā)調(diào)節(jié)：吸氣觸發(fā)調(diào)節(jié)：動態(tài)壓力觸發(fā)技術(shù)動態(tài)流量觸發(fā)技術(shù)“能量轉(zhuǎn)移觸發(fā)”技術(shù)，呼吸機(jī)自動跟蹤調(diào)節(jié)吸氣觸發(fā)水平，即使在大量漏氣時也能保證吸氣同步性 呼氣觸發(fā)調(diào)節(jié)：呼氣觸發(fā)調(diào)節(jié)：呼氣靈敏度手動調(diào)節(jié)范圍10-90%峰流速，保證呼氣同步性，減少提前或延后終止呼吸，避免再次觸發(fā)呼吸機(jī)，或減少肺動態(tài)過度充氣和auto

4、peep產(chǎn)生。自動呼氣觸發(fā)功能：具備先進(jìn)的呼氣觸發(fā)敏感度（ets）自動調(diào)節(jié)功能 resmed自動能量轉(zhuǎn)移觸發(fā)原理示意圖自動能量轉(zhuǎn)移觸發(fā)原理示意圖優(yōu)點：自動能量轉(zhuǎn)移技術(shù)能有效減少患者的呼吸做功優(yōu)點：自動能量轉(zhuǎn)移技術(shù)能有效減少患者的呼吸做功20。 resmed對患者波形的控制對患者波形的控制 方波或遞增波：方波或遞增波：具備氣道壓力上升斜率調(diào)節(jié)功能，適應(yīng)不同病人自主呼吸的吸氣用力的需求，保證了病人舒適性和同步性 減速波形：減速波形： resmed全面、完善、實用的呼吸方式和通氣模式全面、完善、實用的呼吸方式和通氣模式通氣模式預(yù)先設(shè)定功能：通氣模式預(yù)先設(shè)定功能：elisee呼吸機(jī)提供將臨床常用的通氣

5、模式、通氣參數(shù)、報警范圍、監(jiān)測等所有參數(shù)預(yù)先存儲，極大的提高了臨床對呼吸機(jī)快速簡便的使用要求壓力控制呼吸模式：壓力控制呼吸模式：輔助/控制通氣（a/c）、同步間歇指令通氣（simv）、壓力支持通氣（psv）、持續(xù)氣道正壓通氣（cpap）容量控制呼吸模式：容量控制呼吸模式：輔助/控制通氣（a/c）、同步間歇指令通氣（simv）、窒息后備通氣。壓力容量雙控制呼吸模式：壓力容量雙控制呼吸模式：該模式結(jié)合了壓力控制通氣和容量控制通氣的優(yōu)點，設(shè)定最低潮氣量目標(biāo)和最高壓力水平，呼吸機(jī)根據(jù)前次呼吸實際潮氣量和設(shè)定的潮氣量目標(biāo)的差異，自動調(diào)節(jié)輸出壓力水平，盡量達(dá)到設(shè)定的潮氣量目標(biāo)。elisee 呼吸機(jī)還可以在

6、壓力支持條件下在同一次呼吸中保證潮氣量，稱為壓力支持容量保證(ps-vt)。無創(chuàng)呼吸方式：無創(chuàng)呼吸方式：全面兼容各種無創(chuàng)通氣模式，具備超強的自動漏氣補償能力，您無需更換設(shè)備即可實現(xiàn)有創(chuàng)/無創(chuàng)通氣的自由切換 resmed窒息后備保障功能窒息后備保障功能窒息后備通氣：可窒息后備通氣：可精細(xì)預(yù)先設(shè)定在病人窒息觸發(fā)后，elisee呼吸機(jī)將采用何種通氣方式。具備：容量/壓力通氣模式、容量水平/壓力水平、窒息時間、窒息恢復(fù)、窒息報警等內(nèi)容可選。阻力、順應(yīng)性自動補償：阻力、順應(yīng)性自動補償：btps 校正校正 : 氣體溫度和壓力校正氣體溫度和壓力校正 當(dāng)呼吸機(jī)啟用該功能后進(jìn)行自動的校正 僅限于測量呼出潮氣量

7、(vte) if btps = no atpd (ambient temperature pressure & dryness) resmed肺部復(fù)張工具肺部復(fù)張工具什么是肺復(fù)張策略（什么是肺復(fù)張策略（what is a recruitment maneuver）?periodic increase of insufflation pressure beyond the tele-inspiratory pressure released during the conventional ventilation cycles肺復(fù)張的目標(biāo)（肺復(fù)張的目標(biāo)（what is the aim of

8、 a maneuver recruitment） ? to avoid atelectasy : sagging of air cells那些病人需要適用該項功能（那些病人需要適用該項功能（for which patients ）?for neuromuscular patients which air cells could easily collapsenot for copd patients or all obstructive patients !同常規(guī)的嘆息功能比較有什么優(yōu)勢同常規(guī)的嘆息功能比較有什么優(yōu)勢?pressure control. indeed, in case of a

9、 sigh, a volume parameter is set up. therefore the pressure is not controlled. in order to avoid barautroma, an hp alarm must be adjustedlong opening of air cells resmedelisee 呼吸報警設(shè)定、呼吸監(jiān)測界面呼吸報警設(shè)定、呼吸監(jiān)測界面病人數(shù)據(jù)監(jiān)測、存儲、回顧、分析病人數(shù)據(jù)監(jiān)測、存儲、回顧、分析1.壓力波形、流速波形、容量波形，兩種向量環(huán)等動態(tài)波形顯示。2.20多項實時呼吸力學(xué)監(jiān)測，并可根據(jù)需要隨意組合。3.配置先進(jìn)的參數(shù)及波形

10、分析工具，可提供，波形凍結(jié)分析，歷史波形回顧，波形存儲打印等豐富應(yīng)用工具，為臨床診斷及確定治療方案提供豐富參考依據(jù)。 resmed報警設(shè)定報警設(shè)定報警設(shè)定范圍廣泛提供當(dāng)前患者實際通氣數(shù)值為臨床設(shè)定提供依據(jù) resmed呼吸力學(xué)監(jiān)測呼吸力學(xué)監(jiān)測15英寸彩色觸摸屏幕英寸彩色觸摸屏幕 its as easy as 實時實時數(shù)據(jù)數(shù)據(jù)監(jiān)測區(qū)域監(jiān)測區(qū)域當(dāng)前當(dāng)前設(shè)置設(shè)置狀態(tài)狀態(tài)顯示顯示區(qū)域區(qū)域?qū)崟r實時波形波形、向量環(huán)、向量環(huán)監(jiān)測顯示監(jiān)測顯示區(qū)域區(qū)域分析分析工具工具區(qū)域區(qū)域 resmed技術(shù)維護(hù)菜單技術(shù)維護(hù)菜單技術(shù)維護(hù)菜單使得日常維護(hù)工作更為簡單容易技術(shù)維護(hù)菜單使得日常維護(hù)工作更為簡單容易 :調(diào)整呼吸機(jī)的傳感

11、器調(diào)整供氣的傳感器不需要拆卸設(shè)備不需要拆卸設(shè)備 ! 同時按壓下按鈕同時按壓下按鈕 和和 resmed外觀、重量、電源外觀、重量、電源尺寸尺寸 : 290 x 250 x 130 毫米重量重量 :4,5 kg, ventilator only with internal battery0,4 kg, mains supply pack1,1 kg, external battery pack電源電源 :可外接直流電源內(nèi)置電池 : 不低于4小時 外置電池 :不低于4小時 (選配件)ventilation performances are preserved during the whole tim

12、e of discharge resmed擴(kuò)展升級功能（擴(kuò)展升級功能（optional） 5個通氣預(yù)設(shè)程序（標(biāo)準(zhǔn)2個） 霧化吸入 2分鐘純氧吸入 p0.i 、阻力及順應(yīng)性測量 吸氣保持、呼氣保持、手動通氣waking people up to sleep resmedelise操作培訓(xùn)操作培訓(xùn) resmed產(chǎn)品介紹目錄產(chǎn)品介紹目錄呼吸的介紹呼吸回路的連接啟動/關(guān)閉呼吸機(jī)通氣模式通氣參數(shù)報警管理fio2通氣觀測技術(shù)維護(hù)菜單呼吸力學(xué)通氣方式的選擇霧化吸入 resmed成比例三項主動呼氣閥 (雙回路)送氣端口 觸摸屏幕呼吸機(jī)描述呼吸機(jī)描述主電源 / 外接電源狀態(tài)指示燈報警銷音按鈕藍(lán)牙信號指示燈內(nèi)置

13、/ 外置電池狀態(tài)指示燈 resmed呼吸機(jī)描述呼吸機(jī)描述氧電池 開 / 關(guān) 按鈕遠(yuǎn)程報警控制接口信號輸出端口低壓氧源空氣入口空氣入口霧化端口高壓氧源12-28v外接直流電源基座 resmed呼吸回路連接呼吸回路連接連接單/雙肢呼吸回路只需通過卡扣，即可輕松連接/拆卸卡扣基準(zhǔn)點在進(jìn)行手動測試時，能自動探測到呼吸回路連接的方式。不需任何工具不需任何工具 ! resmed呼吸回路連接呼吸回路連接2種呼氣閥可供選擇 : 單回路 呼氣閥上集合了外接呼氣閥控制端口及近端壓力傳感管端口外接呼氣閥控制端口近端壓力傳感線端口病人呼吸回路(直徑 22 mm) resmed呼吸回路連接呼吸回路連接2種呼氣閥可供選擇

14、 : 雙回路 成比例三項主動呼氣閥上集成了多項傳感及控制部分，允許連接雙肢呼吸回路.患者呼氣口吸氣管路 (標(biāo)準(zhǔn)直徑 22 mm)呼氣管路(標(biāo)準(zhǔn)直徑 22 mm) resmed呼吸機(jī)的啟動呼吸機(jī)的啟動通過按壓按右側(cè) 按鈕啟動設(shè)備隨即出現(xiàn)以下歡迎使用界面 :顯示最新的檢測結(jié)果選擇預(yù)先設(shè)定模式選擇設(shè)定新模式選擇先前使用的模式 resmed呼吸機(jī)的關(guān)閉呼吸機(jī)的關(guān)閉通過按壓按右側(cè) 按鈕關(guān)閉設(shè)備依據(jù)當(dāng)前所處的不同狀態(tài), 會出現(xiàn)以下兩種界面中的一個 :確認(rèn)想要關(guān)閉呼吸機(jī)正在通氣正在通氣未啟動通氣未啟動通氣 resmed手動測試手動測試通過做手動測試可以通過做手動測試可以 :探測當(dāng)前患者使用的呼吸回路的類型探

15、測當(dāng)前呼吸回路的阻力 / 順應(yīng)性數(shù)值何時需要做手動測試何時需要做手動測試 ?新的患者使用前通氣程序改變呼吸回路改變在增加 / 減少附件后 (如：濕化器、過濾器 )測試前準(zhǔn)備測試前準(zhǔn)備 :連接好通氣時所需所有附件將呼吸機(jī)同患者之間斷開如未通過測試如未通過測試, 請通知技術(shù)服務(wù)機(jī)構(gòu)請通知技術(shù)服務(wù)機(jī)構(gòu) resmed手動測試手動測試3 個測量階段個測量階段 :傳感器便宜校準(zhǔn) (o2, pressure )吸氣回路阻力校準(zhǔn)呼氣回路阻力 (如使用雙回路), 順應(yīng)性及 o2 傳感器校準(zhǔn) resmed通氣方式選擇通氣方式選擇n 5 個預(yù)設(shè)通氣程序n 存儲了通氣所需調(diào)整所有參數(shù) :- 通氣模式- 患者類型- 通

16、氣參數(shù)- 報警設(shè)置區(qū)別對待患者區(qū)別對待患者 白天白天/夜間夜間 的通氣的通氣需求需求 !減少對醫(yī)護(hù)人員的培訓(xùn)工作減少對醫(yī)護(hù)人員的培訓(xùn)工作 ! resmed通氣方式選擇通氣方式選擇 resmed新模式設(shè)定新模式設(shè)定 按壓 “new patient”按鈕，進(jìn)入新通氣模式設(shè)定程序 隨即，出現(xiàn)如下患者類型選擇界面:each element of the configuration is reminded on the screen thanks to an icon resmed新模式設(shè)定新模式設(shè)定一旦，確認(rèn)了患者通氣類型后, 隨即會出現(xiàn)通氣模式選擇確認(rèn)界面:壓力模式壓力模式容量模式容量模式雙控制模式

17、雙控制模式通氣模式確認(rèn)后, 隨后出現(xiàn)參數(shù)設(shè)定界面 resmed通氣模式通氣模式 : p(a)cvp(a)cv = 輔助輔助/控制通氣模式（壓力控制）控制通氣模式（壓力控制）the ventilator delivers cycles characterized by a fixed insufflations time and pressure parameterpcv = cycles are released by the ventilator, insufflation does not depend on patients effort. a frequency should be a

18、djusted.pacv = inspiration can be released by the patient (trigger)the change from pcv to pacv mode depends on inspiratory triggers adjustmentin p(a)cv mode, the user can set recruitment cyclesmore about recruitment : resmed通氣模式通氣模式 : p(a)cvon p(a)cv mode, the parameters to set are :fio2inspiratory

19、pressurepositive end expiratory pressure (peep)frequencyinspiratory timeflow or pressure inspiratory trigger in invasive ventilationinspiratory trigger in nivinspiratory slope可設(shè)置使用可設(shè)置使用“肺復(fù)張肺復(fù)張”參數(shù)參數(shù) :recruitment periodrecruitment durationrecruitment pressure or resmed通氣模式通氣模式 : p(a)cv 臨床治療應(yīng)用 :as the

20、pressure is controlled, p(a)cv mode is particularly recommended if there is a risk of barautroma or lung infection that could obstruct respiratory tract (inhalation pneumopathy)as the end of inspiratory time is imposed on the patient, the p(a)cv mode could sometimes be uncomfortable because it is no

21、t very adapted to the patients needsthis mode is recommended at the beginning of weaning to facilitate the adaptation of the patient to the ventilator resmed通氣模式通氣模式 : (a)cv(a)cv = 輔助輔助/控制通氣模式（容量控制）控制通氣模式（容量控制）the ventilator delivers cycles characterized by a fixed insufflations time and volume para

22、metercv = cycles are released by the ventilator, insufflation does not depend on patients effort. a frequency should be adjusted.acv = inspiration can be released by the patient (trigger)the change from cv to acv mode depends on inspiratory triggers adjustmentin (a)cv mode, the user can set recruitm

23、ent cyclesmore about recruitment : resmed通氣模式通氣模式 : (a)cvon (a)cv mode, the parameters to set are :fio2tidal volumepositive end expiratory pressure (peep)frequencyinspiratory time or i/e ratio or maxi flowflow or pressure inspiratory trigger in invasive ventilationinspiratory trigger in nivflow shap

24、eplateau timeorrecruitment parameters may be set up :recruitment periodrecruitment durationrecruitment pressure resmed通氣模式通氣模式 : (a)cv 臨床治療應(yīng)用 :the cv mode is recommended when it is better the device totally substitutes itself for the patient ventilationthe acv mode is particularly recommended for pa

25、tients whose ventilation needs could be changed (volume control). it helps to adapt the patient to the ventilator.the setting of volume and frequency alarms is very important in order to avoid hyperventilation risks (exaggerated patients demand) resmed通氣模式通氣模式 : psimvpsimv = 同步間歇指令通氣（壓力控制）同步間歇指令通氣（壓

26、力控制）this ventilation mode allows to alternate pressure assisted controlled ventilation and pressure support (ps) cycles initiated by the patientwhen the psimv mode is selected, an access to “pressure support” adjustment is available from the first screen of parameters adjustmentsuited for weaning an

27、d in case of sedation decreasing ! resmed通氣模式通氣模式 : psimvon psimv mode, the parameters to set are :fio2inspiratory pressurepositive end expiratory pressure (peep)frequencyinspiratory timeinspiratory slopethe adjustable parameters of pressure support are :pressure supportinspiratory slopeflow or pres

28、sure inspiratory trigger in invasive ventilationinspiratory trigger in nivexpiratory triggermaximum inspiratory timeor resmed通氣模式通氣模式 : psimv 臨床治療應(yīng)用 :the psimv mode allows a good distribution of work between the device and the patientit is ideal for weaning and in case of sedation decreasing (gradua

29、l return of patients ventilation autonomy)it is particularly recommended for treatment of chronic respiratory insufficiencies resmed通氣模式通氣模式 : simvsimv =同步間歇指令通氣（容量控制）同步間歇指令通氣（容量控制）this ventilation mode allows to alternate flow assisted controlled ventilation and pressure support (ps) cycles initiat

30、ed by the patientwhen the simv mode is selected, an access to “pressure support” adjustment is available from the first screen of parameters adjustment resmed通氣模式通氣模式 : simvon simv mode, the parameters to set are :fio2tidal volumepositive end expiratory pressure (peep)frequencyinspiratory time or i/

31、e ratio or maxi flowflow shapeplateau timethe adjustable parameters of pressure support are :pressure supportinspiratory slopeflow or pressure inspiratory trigger in invasive ventilationinspiratory trigger in nivexpiratory triggermaximum inspiratory timeor resmed通氣模式通氣模式 : simv 臨床治療應(yīng)用 :the simv mode

32、 allows a good distribution of work between the device and the patientit is ideal for weaning and in case of sedation decreasing (gradual return of patients ventilation autonomy)it is particularly recommended for treatment of chronic respiratory insufficiencies resmed通氣模式通氣模式 : psps = 壓力支持通氣（壓力控制）壓力

33、支持通氣（壓力控制）this mode is a pressure mode assisting the patients spontaneous breathingprinciple :the beginning and the end of the inspiratory cycle are initiated by the patient. however, elise 350 is provided with a minimum frequency parameter : if the number of patient initiated breaths is lower than

34、fmini, the ventilator releases support breaths. resmed通氣模式通氣模式 : psps mode also allows to set an apnea time at the end of which the ventilator switches to backup apnea ventilation if the patient does not initiate a breathapnea ventilation setting is only available when “fmini = no”if the patient ini

35、tiates a breath afterwards, ventilation switches back to pressure supportapnea ventilation in pressureapnea ventilation in volumeapnea ventilation = exclusive to elise 350 ! resmed通氣模式通氣模式 : ps on ps mode, the parameters to set are : fio2 pressure support positive end expiratory pressure (peep) insp

36、iratory slope leak alarm threshold flow or pressure inspiratory trigger in invasive ventilation inspiratory trigger in niv expiratory trigger maximum inspiratory timeor resmed通氣模式通氣模式 : psthe adjustable parameters of pressure support in pressure are : apnea time inspiratory pressure frequency inspir

37、atory time the adjustable parameters of pressure support in volume are : apnea time tidal volume frequency inspiratory time or i/e ratio or maxi flow resmed通氣模式通氣模式 : ps 臨床治療應(yīng)用 :because of its functioning, the ps mode allows to help and reduce the work of respiratory musclestherefore, it is recommen

38、ded for postoperative ventilation rehabilitation and in physiotherapyit is also recommended for weaning resmed通氣模式通氣模式 : ps.vtps-vt = 壓力支持潮氣量保證雙模式通氣（壓力支持潮氣量保證雙模式通氣（pressure support with guaranteed tidal volume）this ventilation mode is described as a dual mode : it requires setting a pressure support

39、 and a target tidal volume that must be reached for each cycleprinciple :the delivered cycle starts in ps ventilation. every 10 minutes, elise 350 calculates if the tidal volume parameter can be delivered, according to the already supplied vt and the remaining inspiratory timeif the calculation fore

40、sees that vt parameter can be reached, then elise 350 stands in pressure support for the rest of the cycleotherwise, if the calculation concludes that vt parameter will not be reached in ps, then elise 350 insufflates the remaining volume while maintaining a constant flow until volume parameter is r

41、eached resmed通氣模式通氣模式 : ps.vtps.vt mode also allows to set an apnea time at the end of which the ventilator switches to apnea ventilation if the patient has not breathedapnea ventilation setting is only available when fmini = noif the patient initiates a breath afterwards, ventilation switches back

42、to pressure supportapnea ventilation = exclusive to elise 350 !apnea ventilation in pressureapnea ventilation in volume resmed通氣模式通氣模式 : ps.vt on ps.vt mode, the parameters to set are : pressure support positive end expiratory pressure (peep) tidal volume leak alarm threshold flow or pressure inspir

43、atory trigger in invasive ventilation inspiratory trigger in niv expiratory trigger maximum inspiratory timeor resmed通氣模式通氣模式 : ps.vtthe adjustable parameters of pressure support in pressure are : apnea time inspiratory pressure frequency inspiratory time the adjustable parameters of pressure suppor

44、t in volume are : apnea time tidal volume frequency inspiratory time or i/e ratio or maxi flow resmed通氣模式通氣模式 : ps.vt 臨床治療應(yīng)用 : ps.vt 模式 : 安全的容量控制模式 舒適的壓力控制模式the ps.vt mode is particularly recommended for patients whose physiological characteristics (resistance ) are likely to changeit is recommended

45、 for patients who are in weaning test of a respiratory insufficiency resmed通氣模式通氣模式 : cpap cpap = 持續(xù)氣道正壓通氣the patient can breathe spontaneously thanks to a peep levelthe device counters the depression caused by the inspiration with a flow increase. during expiration, a back pressure on the exhalatio

46、n valve maintains the expiratory pressure at the pressure level set by the user 在 cpap 模式, 僅可設(shè)置的參數(shù) : 持續(xù)壓力的水平 resmed通氣模式通氣模式 : cpap 臨床治療 應(yīng)用: 阻塞性睡眠呼吸暫停（obstructive apnea sleep syndrome） 肺動脈瓣狹窄（pulmonary oedema） resmed通氣參數(shù)定義通氣參數(shù)定義pressure support (cmh2o) :在患者吸氣循環(huán)中呼吸機(jī)在peep壓力之上，額外給予的一個壓力水平maxi flow (l/mi

47、n) :呼吸機(jī)給患者供氣時所能提供的最大吸氣流速，在容量控制通氣中會直接影響到所需吸氣時間的長短flow shape :僅在容量控制模式中有效,可以患者吸氣項進(jìn)行持續(xù)遞增或遞減流速frequency (cycles/min) :一分鐘內(nèi)所呼吸總的次數(shù)inspiratory slope :僅在壓力控制模式中有效, 其意義為要達(dá)到設(shè)定的目標(biāo)壓力值而所需要花費的時間 resmed通氣參數(shù)定義通氣參數(shù)定義positive end expiratory pressure (cmh2o) :由呼吸機(jī)維持的，患者在呼氣循環(huán)期間持續(xù)保持的一個正壓力inspiratory pressure (cmh2o) :患

48、者在輔助/控制呼吸循環(huán)中的吸氣項時，呼吸機(jī)提供的一個高于peep的壓力值i/e ratio (1/x) :在1次呼吸中，吸氣所用時間和呼氣所用時間之間的比值apnea time (s) :僅在自主呼吸模式下有效, 其表示為一段時間區(qū)間之后，如呼吸機(jī)未探測到患者的呼吸循環(huán)，患者可能出了現(xiàn)窒息的狀況。 resmed通氣參數(shù)定義通氣參數(shù)定義inspiratory time (s) :從吸氣流速而時間區(qū)間time space between the beginning of inspiratory flow and the beginning of expiratory flowmaximum ins

49、piratory time (s) :呼吸機(jī)向患者輸入氣體所需最長時間區(qū)間，設(shè)定潮氣量達(dá)到與否expiratory trigger :達(dá)到一個規(guī)定的界定值時，引起的呼氣循環(huán). 定義為最大峰值流速的% 或自動觸發(fā)標(biāo)準(zhǔn)inspiratory trigger :達(dá)到一個規(guī)定的界定值時，引起的吸氣循環(huán). 觸發(fā)的方式有 :流速觸發(fā)（flow trigger）壓力觸發(fā)（pressure trigger）在無創(chuàng)通氣中的觸發(fā)（non invasive trigger） resmed通氣參數(shù)定義通氣參數(shù)定義tidal volume (ml) :吸氣或呼氣時間內(nèi)患者所吸入或呼出的氣體容量fio2 (%) :患者吸

50、入氣體內(nèi)氧氣所占的百分比plateau time (s) :time during which insufflation is maintained nil at the patient level resmed參數(shù)設(shè)置參數(shù)設(shè)置要設(shè)置某項參數(shù)時, 只需按壓下相對應(yīng)的圖標(biāo)隨即彈出增減調(diào)節(jié)按鈕 和 調(diào)整至需要使用的數(shù)值后, 按壓 按鈕進(jìn)行確認(rèn)修改提示但前通氣模式提示但前患者狀態(tài)返回至模式設(shè)定界面 確認(rèn)后進(jìn)入報警設(shè)置界面按壓“start ventilation”開始通氣其它參數(shù)設(shè)定界面 resmed擴(kuò)展特點擴(kuò)展特點進(jìn)入擴(kuò)展特點設(shè)置界面 : resmed擴(kuò)展特點擴(kuò)展特點btps 校正校正 : 氣體溫度

51、和壓力校正氣體溫度和壓力校正當(dāng)呼吸機(jī)啟用該功能后進(jìn)行自動的校正僅限于測量呼出潮氣量 (vte)if btps = no atpd (ambient temperature pressure & dryness)rc 自動測量自動測量患者肺部力學(xué)情況 :每隔 15 分鐘自動測量阻力和順應(yīng)性僅有限于在有創(chuàng)通氣的acv 模式 resmed擴(kuò)展特點擴(kuò)展特點多種氧源多種氧源 高壓高壓 / 低壓氧源低壓氧源更好的適合各種供氧條件可在可在ti, maximum flow 或或 i/e 中選擇使用查看方式中選擇使用查看方式:僅限于在 acv 模式 ! resmed報警管理報警管理 two indepe

52、ndent systems to trigger audible alarms 1 voice synthesis adjustable volume controlled by the main microprocessor 1 buzzer controlled by : the main microprocessor the alarm microprocessor an hardware independent system supplied by an extra battery resmed通氣報警通氣報警需要設(shè)置報警參數(shù)時，可通過按壓 按鈕直接進(jìn)入呼吸機(jī)報警設(shè)置界面隨即出現(xiàn)如圖參

53、數(shù) : 報警參數(shù)的調(diào)節(jié)方式和通氣參數(shù)調(diào)節(jié)方式是一樣的！報警參數(shù)的調(diào)節(jié)方式和通氣參數(shù)調(diào)節(jié)方式是一樣的！ resmedfio2低壓供氧低壓供氧供氣口壓力不超過 400 kpa氧氣供給方式 :- an oxygen bottle equipped with a rotameter and pressure reducer- an o2 concentrator- an o2 wall-gas supply equipped with a rotameter elise 350 automatically manages fio2 value according to fio2 parameter r

54、esmedfio2高壓氧源高壓氧源供氣口壓力范圍為240 kpa 至 700 kpa之間供氧方式 :- 墻壁供氧- 帶減壓調(diào)節(jié)裝置的氧氣瓶 elise 350 automatically manages fio2 value according to fio2 parameter resmedfio22分鐘純氧功能（分鐘純氧功能（o2 100 %）- 按壓 圖標(biāo)按鈕后可獲得兩分鐘的純氧通氣 - 在使用高壓供氧方式時，該功能有效低壓供氧低壓供氧高壓供氧高壓供氧 resmedfio2空氣和氧氣的混合過程是在氣體輸入渦輪之前完成的?？諝夂脱鯕獾幕旌线^程是在氣體輸入渦輪之前完成的。依靠成比例閥門對依靠

55、成比例閥門對flow-by進(jìn)行精確控制進(jìn)行精確控制 (proportional valve)elise 150 能自動調(diào)節(jié) flow-by 水平，通過吸入氣體流速和流速觸發(fā)值o2flow-by with oxygen+/- inspiratory flow+/- flow trigger +/- flow-by resmedfio2圖形圖形 :inspi.expi.流速曲線o2 concentration at level patientsaime systemother systeman important oxygen peak can be delivered at the very b

56、eginning of the inspiration phase where the flow is the most important減少對氧氣的消耗減少對氧氣的消耗 resmed通氣觀察通氣觀察when the ventilation begins, a screen that allows to control on ventilation curves automatically appears from that screen, the user can have a look at the ventilation thanks to the following elements

57、 :bargraph of instantaneous pressurepressure curve flow curve ventilation measurestrigger resmed通氣觀察通氣觀察by pressing on one of the 4 displayed measures at the bottom of the screen, you have direct access to the measures screen choice between 11 measuresreal time display of the values resmed通氣觀察通氣觀察fr

58、om curves screen, the evolution of measures can be frozen by pressing one of the curvespress on any point of the curves to display the corresponding valuepossibility to determine value between two points resmed治療控制治療控制 : 事件回放事件回放 the journal of events registers : the whole of alarms release / stop e

59、very act made on the ventilator : start / stop of the ventilation start / stop of the ventilator change of the ventilation parameters value start / stop of the alarms change of the alarms threshold resmed呼吸力學(xué)測量選項呼吸力學(xué)測量選項通氣時可選擇使用多種呼吸力學(xué)測量工具使用的有效性要依據(jù)所處在的通氣方式或通氣模式用戶可以通過在曲線監(jiān)測屏幕下，通過翻頁找到相關(guān)需要的測量工具p0.1胸腔閉合壓力胸腔閉合壓力 霧化功能霧化功能吸氣保持吸氣保持呼氣保持呼氣保持手動通氣手動通氣阻力阻力 / 順應(yīng)性順應(yīng)性 resmed呼吸力學(xué)測量選項呼吸力學(xué)測量選項吸氣保持功能吸氣保持功能- it is carried out at the end of the inspiratory cycle when the tidal volume is delivered.- a nil flow is manually maintained.- the pause cannot exceed 5 seconds. after this time, an exhalation cycle is aut