Đang chuẩn bị nút TẢI XUỐNG, xin hãy chờ
Tải xuống
Không oxy, tuy nhiên, được xử lý bằng cách khôi phục và duy trì khối lượng phổi bằng cách sử dụng các thao tác tuyển dụng phế nang chẳng hạn như các ứng dụng của một kết thúc kỳ thở áp lực dương (PEEP hoặc CPAP). Hình 4,5 tóm tắt các loại khác nhau của hỗ trợ hô hấp. | 58 Chapter 4 designed to increase alveolar minute ventilation by increasing the depth and rate of breathing. Failure to oxygenate however is treated by restoring and maintaining lung volumes using alveolar recruitment manoeuvres such as the application of a positive end-expiratory pressure PEEP or CPAP . Fig. 4.5 summarises the different types of respiratory support. There is considerable evidence available as to what works best in different clinical situations 1 . This information is important. For example there is no evidence that trying non-invasive ventilation NIV in a young person with life-threatening asthma is of any benefit. The first-line methods of respiratory support for different conditions are shown in Fig. 4.6. Figure 4.5 Different types of respiratory support. BiPAP bilevel positive pressure ventilation IPPV intermittent positive pressure ventilation CPAP continuous positive airway pressure SIMV synchronised intermittent mandatory ventilation PSV pressure support ventilation. Tracheal intubation Non-invasive ventilation NIV BiPAP Non-invasive CPAP Asthma ARDS acute respiratory distress syndrome Severe respiratory acidosis causing pH 7.25 Any cause with impaired conscious level Pneumonia COPD with respiratory acidosis causing pH 7.25-7.35 Decompensated sleep apnoea Acute on chronic hypercapnic respiratory failure due to chest wall deformity or neuromuscular disease Acute cardiogenic pulmonary oedema Hypoxaemia in chest trauma atelectasis Figure 4.6 First-line methods of respiratory support for different conditions. If NIV or CPAP is used as a trial of treatment in pneumonia in patients without COPD or postoperative respiratory failure this should be done on an ICU with close monitoring and rapid access to intubation. Patients with excessive secretions may also require tracheal intubation. Respiratory failure 59 Non-invasive respiratory support Non-invasive respiratory support will be more familiar to people who do not work on an intensive care unit .
