Elisee350中文操作培訓

1、Waking people up to sleep. ResMed ResMed 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 ResMed ResMed患者適用范圍患者適用范圍 ICU / CCU 呼吸機呼吸機 壓力壓力 & 容量控制呼吸機容量控制呼吸機 有創(chuàng)有創(chuàng) & 無創(chuàng)呼吸機無創(chuàng)呼吸機 單單 & 雙呼吸回路系統(tǒng)雙呼吸回路系統(tǒng) 成人成人 & 兒童呼吸機兒童呼吸機 （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 Res

2、Med 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 圖形文字對照-極易操作使用l 通氣程序預設-快速啟動l 具備模式、參數(shù)、報警、監(jiān)測各自獨立的設定頁面。 . ResMed ResMed ResMed 整體化氣路結構整體化氣路結構堅固的整體、一體化的氣路結構-堅固耐用，故障率低-緊湊的氣路機械死腔最小，反應最快，呼吸同步性更好-氣路系統(tǒng)的順應性更小，呼吸機的壓力/流量/容量輸出更精確-一體化設計融合了當今工業(yè)設計、制造和工藝最新技術. ResMed ResMed 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)

3、 -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300升/分。 -體積小、噪音低、慣性及功耗極低 -能夠瞬間準確調(diào)節(jié)供氣流速，與患者自主呼吸匹配，最大程度縮短吸氣及呼氣的反應時間。成比例三項主動呼氣閥技術成比例三項主動呼氣閥技術 . ResMed ResMed ResMed“人機協(xié)調(diào)性人機協(xié)調(diào)性”觸發(fā)技術觸發(fā)技術 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，先進的吸氣觸發(fā)技術，保證了優(yōu)異的人機同步性/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)技術動態(tài)流量觸發(fā)技術“能量轉(zhuǎn)移觸發(fā)”技術，呼吸機自動跟蹤調(diào)節(jié)吸氣觸發(fā)水平，即使在大量漏

4、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，或減少肺動態(tài)過度充氣和AutoPEEP產(chǎn)生。自動呼氣觸發(fā)功能：具備先進的呼氣觸發(fā)敏感度（ETS）自動調(diào)節(jié)功能. ResMed ResMed 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)移技術能有效減少患者的呼吸做功優(yōu)點：自動能量轉(zhuǎn)移技術能有效減少患者的呼吸做功20。. ResMed ResMed 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，適應不同

5、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 ResMed 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先設定功能：通氣模式預先設定功能：Elisee呼吸機提供將臨床常用的通氣模式、通氣參數(shù)、報警范圍、監(jiān)測等所有參數(shù)預先存儲，極大的提高了臨床對呼吸機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）

6、、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：該模式結合了壓力控制通氣和容量控制通氣的優(yōu)點，設定最低潮氣量目標和最高壓力水平，呼吸機根據(jù)前次呼吸實際潮氣量和設定的潮氣量目標的差異，自動調(diào)節(jié)輸出壓力水平，盡量達到設定的潮氣量目標。Elisee 呼吸機還可以在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，您無需更換設備即可實現(xiàn)有創(chuàng)/無創(chuàng)通氣的自由切換. ResMed ResMed 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：可精細預先設定在

7、病人窒息觸發(fā)后，Elisee呼吸機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、窒息報警等內(nèi)容可選。阻力、順應性自動補償：阻力、順應性自動補償：BTPS 校正校正 : 氣體溫度和壓力校正氣體溫度和壓力校正 當呼吸機啟用該功能后進行自動的校正 僅限于測量呼出潮氣量 (Vte) If BTPS = NO ATPD (Ambient Temperature Pressure & Dryness). ResMed ResMed ResMed肺部復張工具肺部復張工具什么是肺復張策略（什么是肺復張策略（What is a recruitment maneuv

8、er）?Periodic increase of insufflation pressure beyond the tele-inspiratory pressure released during the conventional ventilation cycles肺復張的目標（肺復張的目標（What is the aim of 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

9、 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 sigh, a volume parameter is set up. Therefore the pressure is not controlled. In order to avoid barautroma, An HP alarm must be adju

10、stedLong opening of air cells. ResMed ResMed ResMedElisee 呼吸報警設定、呼吸監(jiān)測界面呼吸報警設定、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。20多項實時呼吸力學監(jiān)測，并可根據(jù)需要隨意組合。配置先進的參數(shù)及波形分析工具，可提供，波形凍結分析，歷史波形回顧，波形存儲打印等豐富應用工具，為臨床診斷及確定治療方案提供豐富參考依據(jù)。 . ResMed ResMed ResMed報警設定報警設定報警設定范圍廣泛提供當前患者實際通氣數(shù)值為臨床設定提供依據(jù). ResM

11、ed ResMed ResMed呼吸力學監(jiān)測呼吸力學監(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)域當前當前設置設置狀態(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 ResMed ResMed技術維護菜單技術維護菜單技術維護菜單使得日常維護工作更為簡單容易技術維護菜單使得日常維護工作更為簡單容易 :調(diào)整呼吸機的傳感器調(diào)整供氣的傳感器不需要拆卸設備不需要拆卸設備 ! 同時按壓下按鈕同時按壓下按鈕 和和. ResMed ResMed ResMed外觀、重量、電源外觀、重量

12、、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 time of discharge. ResMed ResMed ResMed擴展升級功能（擴展升級功能（Optional） 5個通

13、氣預設程序（標準2個） 霧化吸入 2分鐘純氧吸入 P0.I 、阻力及順應性測量 吸氣保持、呼氣保持、手動通氣Waking people up to sleep. ResMed ResMed ResMedElise操作培訓操作培訓. ResMed ResMed 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/關閉呼吸機通氣模式通氣參數(shù)報警管理FiO2通氣觀測技術維護菜單呼吸力學通氣方式的選擇霧化吸入. ResMed ResMed ResMed成比例三項主動呼氣閥 (雙回路)送氣端口 觸摸屏幕呼吸機描述呼吸機描述主電源 / 外接電源狀態(tài)指示燈報警銷音按鈕藍牙信號指示燈內(nèi)置 / 外

14、置電池狀態(tài)指示燈. ResMed ResMed ResMed呼吸機描述呼吸機描述氧電池 開 / 關 按鈕遠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 ResMed 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/拆卸卡扣基準點在進行手動測試時，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 ResMed 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

15、呼吸回路(直徑 22 mm). ResMed ResMed ResMed呼吸回路連接呼吸回路連接2種呼氣閥可供選擇 : 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 (標準直徑 22 mm)呼氣管路(標準直徑 22 mm). ResMed ResMed ResMed呼吸機的啟動呼吸機的啟動通過按壓按右側(cè) 按鈕啟動設備隨即出現(xiàn)以下歡迎使用界面 :顯示最新的檢測結果選擇預先設定模式選擇設定新模式選擇先前使用的模式. ResMed ResMed ResMed呼吸機的關閉呼吸機的關閉通過按壓按右側(cè) 按鈕關閉設備依據(jù)當前所處的不同狀態(tài), 會出現(xiàn)以下兩種

16、界面中的一個 :確認想要關閉呼吸機正在通氣正在通氣未啟動通氣未啟動通氣. ResMed ResMed 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 :探測當前患者使用的呼吸回路的類型探測當前呼吸回路的阻力 / 順應性數(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 )測試前準備測試前準備 :連接好通氣時所需所有附件將呼吸機同患者之間斷開如未通過測試如未通過測試, 請通知技術服務機構請通知技術服務機構. ResMed ResMed 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

17、準 (O2, pressure )吸氣回路阻力校準呼氣回路阻力 (如使用雙回路), 順應性及 O2 傳感器校準. ResMed ResMed ResMed通氣方式選擇通氣方式選擇n 5 個預設通氣程序n 存儲了通氣所需調(diào)整所有參數(shù) :- 通氣模式- 患者類型- 通氣參數(shù)- 報警設置區(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)護人員的培訓工作減少對醫(yī)護人員的培訓工作 !. ResMed ResMed ResMed通氣方式選擇通氣方式選擇. ResMed ResMed ResMed新模式設定新模式設定 按壓 “New patient”按鈕，進入新通氣模式設定程序

18、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 ResMed ResMed新模式設定新模式設定一旦，確認了患者通氣類型后, 隨即會出現(xiàn)通氣模式選擇確認界面:壓力模式壓力模式容量模式容量模式雙控制模式雙控制模式通氣模式確認后, 隨后出現(xiàn)參數(shù)設定界面. ResMed ResMed 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 delive

19、rs 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 adjusted.PACV = inspiration can be released by the patient (trigger)The change from PCV to PACV mode depends

20、 on inspiratory triggers adjustmentIn P(A)CV mode, the user can set recruitment cyclesMore about recruitment :. ResMed ResMed ResMed通氣模式通氣模式 : P(A)CVOn P(A)CV mode, the parameters to set are :FiO2Inspiratory PressurePositive End Expiratory Pressure (PEEP)FrequencyInspiratory timeFlow or Pressure Ins

21、piratory trigger in Invasive ventilationInspiratory trigger in NIVInspiratory slope可設置使用可設置使用“肺復張肺復張”參數(shù)參數(shù) :Recruitment periodRecruitment durationRecruitment pressure or. ResMed ResMed ResMed通氣模式通氣模式 : P(A)CV 臨床治療應用 :As the pressure is controlled, P(A)CV mode is particularly recommended if there is a

22、 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 not very adapted to the patients needsThis mode is recommended at the beginning

23、 of weaning to facilitate the adaptation of the patient to the ventilator . ResMed ResMed 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 parameterCV = cycles are released by the ventilator, insufflation

24、 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 recruitment cyclesMore about recruitment :. ResMed ResMed ResMed通氣模式通

25、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 shapePlateau timeorRecruitment parameters may be s

26、et up :Recruitment periodRecruitment durationRecruitment pressure . ResMed ResMed ResMed通氣模式通氣模式 : (A)CV 臨床治療應用 :The CV mode is recommended when it is better the device totally substitutes itself for the patient ventilationThe ACV mode is particularly recommended for patients whose ventilation needs

27、 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 ResMed 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（壓力控制）This venti

28、lation 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 and in case of s

29、edation decreasing !. ResMed ResMed 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 Pre

30、ssure Inspiratory trigger in Invasive ventilationInspiratory trigger in NIVExpiratory triggerMaximum inspiratory timeor. ResMed ResMed ResMed通氣模式通氣模式 : PSIMV 臨床治療應用 :The PSIMV mode allows a good distribution of work between the device and the patientIt is ideal for weaning and in case of sedation de

31、creasing (gradual return of patients ventilation autonomy)It is particularly recommended for treatment of chronic respiratory insufficiencies. ResMed ResMed 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 Press

32、ure Support (PS) cycles initiated by the patientWhen the SIMV mode is selected, an access to “Pressure Support” adjustment is available from the first screen of parameters adjustment. ResMed ResMed ResMed通氣模式通氣模式 : SIMVOn SIMV mode, the parameters to set are :FiO2Tidal VolumePositive End Expiratory

33、Pressure (PEEP)FrequencyInspiratory time or I/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 time

34、or. ResMed ResMed ResMed通氣模式通氣模式 : SIMV 臨床治療應用 :The SIMV mode 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 respi

35、ratory insufficiencies. ResMed ResMed ResMed通氣模式通氣模式 : PSPS = 壓力支持通氣（壓力控制）壓力支持通氣（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 fre

36、quency parameter : if the number of patient initiated breaths is lower than Fmini, the ventilator releases support breaths. ResMed ResMed 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 initia

37、te a breathApnea ventilation setting is only available when “Fmini = NO”If the patient initiates a breath afterwards, ventilation switches back to Pressure SupportApnea ventilation in pressureApnea ventilation in volumeApnea ventilation = Exclusive to Elise 350 !. ResMed ResMed ResMed通氣模式通氣模式 : PS O

38、n PS mode, the parameters to set are : FiO2 Pressure Support Positive End Expiratory Pressure (PEEP) Inspiratory slope Leak Alarm threshold Flow or Pressure Inspiratory trigger in Invasive ventilation Inspiratory trigger in NIV Expiratory trigger Maximum inspiratory timeor. ResMed ResMed ResMed通氣模式通

39、氣模式 : PSThe adjustable parameters of Pressure Support in pressure are : Apnea Time Inspiratory Pressure Frequency Inspiratory 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 ResMed ResMed通氣模式通氣模式

40、: PS 臨床治療應用 :Because of its functioning, the PS mode allows to help and reduce the work of respiratory musclesTherefore, it is recommended for postoperative ventilation rehabilitation and in physiotherapyIt is also recommended for weaning. ResMed ResMed ResMed通氣模式通氣模式 TPS-VT = 壓力支持潮氣量保證雙模式通氣（壓力支持潮氣量

41、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 and a target tidal volume that must be reached for each cyclePrinciple :The delivered cycle starts in PS ventilation. Every 10 minutes, Elise 350 calculate

42、s if the tidal volume parameter can be delivered, according to the already supplied Vt and the remaining inspiratory timeIf the calculation foresees 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 pa

43、rameter will not be reached in PS, then Elise 350 insufflates the remaining volume while maintaining a constant flow until volume parameter is reached. ResMed ResMed ResMed通氣模式通氣模式 TT mode also allows to set an apnea time at the end of which the ventilator switches to apnea ventilation if the patien

44、t has not breathedApnea ventilation setting is only available when Fmini = NOIf the patient initiates a breath afterwards, ventilation switches back to pressure supportApnea ventilation = Exclusive to Elise 350 !Apnea ventilation in pressureApnea ventilation in volume. ResMed ResMed ResMed通氣模式通氣模式 T

45、T mode, the parameters to set are : Pressure Support Positive End Expiratory Pressure (PEEP) Tidal Volume Leak Alarm threshold Flow or Pressure Inspiratory trigger in Invasive ventilation Inspiratory trigger in NIV Expiratory trigger Maximum inspiratory timeor. ResMed ResMed ResMed通氣模式通氣模式 TThe adju

46、stable parameters of Pressure Support in pressure are : Apnea time Inspiratory pressure Frequency Inspiratory 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 ResMed ResMed通氣模式通氣模式 T 臨床治療應用 : T 模式

47、: 安全的容量控制模式 舒適的壓力控制模式T mode is particularly recommended for patients whose physiological characteristics (resistance ) are likely to changeIt is recommended for patients who are in weaning test of a respiratory insufficiency. ResMed ResMed ResMed通氣模式通氣模式 : CPAP CPAP = 持續(xù)氣道正壓通氣The patient can breathe

48、 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 exhalation valve maintains the expiratory pressure at the pressure level set by the user 在 CPAP 模式, 僅可設置的參數(shù) : 持續(xù)壓力的水平. ResMed ResMed ResMe

49、d通氣模式通氣模式 : CPAP 臨床治療 應用: 阻塞性睡眠呼吸暫停（Obstructive Apnea Sleep syndrome） 肺動脈瓣狹窄（Pulmonary oedema）. ResMed ResMed 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)中呼吸機在PEEP壓力之上，額外給予的一個壓力水平Maxi flow (l/min) :呼吸機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,可以患者吸氣項進行持續(xù)遞增或遞減流速Frequency

50、 (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, 其意義為要達到設定的目標壓力值而所需要花費的時間. ResMed ResMed ResMed通氣參數(shù)定義通氣參數(shù)定義Positive End Expiratory Pressure (cmH2O) :由呼吸機維持的，患者在呼氣循環(huán)期間持續(xù)保持的一個正壓力Inspiratory Pressure (cmH2O) :患者在輔助/控制呼吸循環(huán)中的吸氣項時，呼吸機提供的一個高于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

51、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 ResMed 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 Inspiratory Time (s) :呼吸機向患者輸入氣體所需最長時間區(qū)間，設定潮氣量達到與否Expiratory Trigger :達到

52、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)標準Inspiratory Trigger :達到一個規(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 ResMed 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 (%) :患者吸入氣體內(nèi)氧氣所占的百分比Plateau time (s) :Time during which insuff

53、lation is maintained nil at the patient level. ResMed ResMed ResMed參數(shù)設置參數(shù)設置要設置某項參數(shù)時, 只需按壓下相對應的圖標隨即彈出增減調(diào)節(jié)按鈕 和 調(diào)整至需要使用的數(shù)值后, 按壓 按鈕進行確認修改提示但前通氣模式提示但前患者狀態(tài)返回至模式設定界面 確認后進入報警設置界面按壓“start ventilation”開始通氣其它參數(shù)設定界面. ResMed ResMed ResMed擴展特點擴展特點進入擴展特點設置界面 :. ResMed ResMed ResMed擴展特點擴展特點BTPS 校正校正 : 氣體溫度和壓力校正氣體溫度

54、和壓力校正當呼吸機啟用該功能后進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情況 :每隔 15 分鐘自動測量阻力和順應性僅有限于在有創(chuàng)通氣的ACV 模式. ResMed ResMed ResMed擴展特點擴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 ResMed ResM

55、ed報警管理報警管理 Two independent 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 ResMed ResMed通氣報警通氣報警需要

56、設置報警參數(shù)時，可通過按壓 按鈕直接進入呼吸機報警設置界面隨即出現(xiàn)如圖參數(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！. ResMed ResMed 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 automatical

57、ly manages FiO2 value according to FiO2 parameter. ResMed ResMed ResMedFiO2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. ResMed ResMed ResMedFiO22分鐘純氧功能（分鐘純氧功能（O2 100 %）- 按壓 圖標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

58、低壓供氧高壓供氧高壓供氧. ResMed ResMed ResMedFiO2空氣和氧氣的混合過程是在氣體輸入渦輪之前完成的。空氣和氧氣的混合過程是在氣體輸入渦輪之前完成的。依靠成比例閥門對依靠成比例閥門對flow-by進行精確控制進行精確控制 (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. ResMed ResMed ResMedFiO2圖形圖形 :Inspi.Expi.流速曲線O

59、2 concentration at level patientSAIME systemOther systemAn important oxygen peak can be delivered at the very beginning 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 ResMed ResMed通氣觀察通氣觀察When the ventilation begins, a screen that allows to control on ventilati

60、on curves automatically appears From that screen, the user can have a look at the ventilation thanks to the following elements :Bargraph of instantaneous pressurePressure curve Flow curve Ventilation measuresTrigger. ResMed ResMed ResMed通氣觀察通氣觀察By pressing on one of the 4 displayed measures at the bottom of the screen, y