OLT.ppt

Ⅴ Keep lung open 10-04-28 ? MAQUET * 再调降pc level maintain same Vt Open Lung Tools Compare the compliance 10-04-28 ? MAQUET * before and after RM (14→37.4) Open Lung Tools Lung Recruitment Protocol 10-04-28 ? MAQUET * Open Lung Tools FiO2≥50% or PaO2/FiO2≤200 询问Dr. 是否执行 Hemodynamic stable Hemodynamic stable 是, sedation use (paralized) PCV mode, keep Vt 6-8ml/Kg, RR:15次/分,I/E:1:1, FiO2:100%, PEEP:20 ↑pl 3 cmH2O/1~2次呼吸, 至PIP=60cmH2O SBP90 mmHg 调回原先pl, ↓PEEP 1cmH2O/1~2次呼吸直至closing pressure 出現 PlP 60cmH2O, PEEP:20 keep 2 min PEEP调至closing pressure+2, 调整pl至所需Vt, 调整RR, FiO2 *三班各做一次 or if FiO2↑≥20%需执行(只需做recruitment) *FiO240% or PaO2/FiO2≥300 可停止执行 Fluid challenge or inotropic agent use 否 否 Lung Recruitment 是,find closing pressure Re-open Keep open Lung Recruitment Protocol 10-04-28 ? MAQUET * Open Lung Tools 病人由POR返室接上MV, vital sign stable Dr. 一起参与 MV setting: PCV mode, 渐增pl3cmH2O/1~2次呼吸直至PIP40, PEEP:15cmH2O, RR:10次/分,I/E:1:1 Maintain 2 min Vital sign stable FiO2?30% 是 调回基本设定 是 再做一次 否 FiO2调高至?40%再做一次 Fluid challenge or inotropic agent use 否 询问医师下一步处理 Stop 未改善 改善 THANK YOU! 10-04-28 ? MAQUET * Mobile: E-mail: g.ji@maquet.de Sevice hotline: 4008203072 * This is the standard title slide with the “corporate” image motif. The image is merely a placeholder. The image can be changed using “View – Master – Slide Master”. The image has to be entirely within the frame. * Images can be formatted using the function “Cut” (drawing toolbar). Reduction of the resolution of the entire presentation using the function “Compress images” (drawing toolbar). Where possible, however, the resolution should be reduced before the image is inserted. * Images can be formatted using the function “Cut” (drawing toolbar). Reduction of the resolution of the entire presentation using the function “Compress images” (drawing toolbar). Where possible, however, the resolution should be reduced before the image is inserted. * Use as little text as possible (key wo