CS233303B1 - Control system of automatic apparatus for artificial respiration with pressure, interval or volume control - Google Patents
Control system of automatic apparatus for artificial respiration with pressure, interval or volume control Download PDFInfo
- Publication number
- CS233303B1 CS233303B1 CS797058A CS705879A CS233303B1 CS 233303 B1 CS233303 B1 CS 233303B1 CS 797058 A CS797058 A CS 797058A CS 705879 A CS705879 A CS 705879A CS 233303 B1 CS233303 B1 CS 233303B1
- Authority
- CS
- Czechoslovakia
- Prior art keywords
- valve
- control system
- control
- artificial respiration
- logic
- Prior art date
Links
- 230000029058 respiratory gaseous exchange Effects 0.000 title claims 6
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims 3
- 229910052760 oxygen Inorganic materials 0.000 claims 3
- 239000001301 oxygen Substances 0.000 claims 3
- 230000003068 static effect Effects 0.000 claims 2
- 238000012544 monitoring process Methods 0.000 claims 1
- 230000011664 signaling Effects 0.000 claims 1
- 244000144985 peep Species 0.000 description 6
- 235000017399 Caesalpinia tinctoria Nutrition 0.000 description 2
- 241000388430 Tara Species 0.000 description 2
- 101100087393 Caenorhabditis elegans ran-2 gene Proteins 0.000 description 1
- WMDZARSFSMZOQO-DRZSPHRISA-N Ile-Phe Chemical compound CC[C@H](C)[C@H](N)C(=O)N[C@H](C(O)=O)CC1=CC=CC=C1 WMDZARSFSMZOQO-DRZSPHRISA-N 0.000 description 1
- 241001553014 Myrsine salicina Species 0.000 description 1
- ACHQFNGCBWWVRR-UHFFFAOYSA-N NOPO Chemical compound NOPO ACHQFNGCBWWVRR-UHFFFAOYSA-N 0.000 description 1
- 235000011449 Rosa Nutrition 0.000 description 1
- 240000007313 Tilia cordata Species 0.000 description 1
- 239000002002 slurry Substances 0.000 description 1
- 238000009423 ventilation Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0057—Pumps therefor
- A61M16/0078—Breathing bags
Landscapes
- Health & Medical Sciences (AREA)
- Emergency Medicine (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Respiratory Apparatuses And Protective Means (AREA)
- Crystals, And After-Treatments Of Crystals (AREA)
Description
'W'W
JÍM PRO VYNÁLEZY A OBJEVY CAS:THE CASE FOR INVENTIONS AND CASE DISCOVERIES:
OSOB./POŠTAVYftfZOSOB./POŠTAVYftfZ
co σ o w. r~what σ o w. r ~
O ΓΟ :CO ,O ΓΟ: CO,
>—. I> -. AND
C5 I O.C5 I O.
HA3BAHIÍE H30EPETEHHHHA3BAHIÍE H30EPETEHHH
YnpaBjíeHHe sjlh aBTOMaTHHecKHX araiapaTOB HCKyccTBeHHoro jíh-xaHKS c ynpaBJíeHxeM .naBJreHHH, HHTepBajioB hjih oÓBewa. OEJIACTB ΙΜΜΕΗΗΗ Ϊ430ΕΡΕΤΕΗΗΗYnpaBjieHHe sjlh aBTOMaTHHecKHX araiapaTOB HCKyccTBeHHoro jih-xaHKS c ynpaBJeHxeM .naBJreHHH, HHTepBajioB hjih oÓBewa. OEJIACTB ΙΜΜΕΗΗΗ 30430ΕΡΕΤΕΗΗΗ
TfeodpeTeHxe othochtch k ynpaBJíeHiro jw aBTOMaTHHecKEX anna- • paTOB HCKyccTBeHHoro SHxaHHH c ynpaBJíeHHeM saBJíeHHH, HHrep- -BajiOB mí odteMOB Λ7ΙΗ nojínepKKBaeMoro h KOHTpojmpyeMoro HC-KyccTBeHHoro ΚΗΧΗΗΗΗ, COCTOflmeMy H3 ΠΗΘΒΜΟ—ΛΟΓΗΉβΟΚΗΧ nepe-KJwaTejiBHHX e ynpaBJíHWix sJíeiaeHujOB, co cxeMofl ynpaBJíeHEHftJIH HHTepMETTEpyE^erO npEHyíMTSJIBHOrO ECKyCCTBeHHOrO ,ws-HHH ( IMV ), K KOTOPOE ϋΟβΚΛΚΗβΗΗ Cpe^CTBa-M £03Hp0BKH 02,3aErKTH OT Ε30ΗΤ0ΗΗ0Γ0 SaBJíeHEH H KOMneHCaííHH JíaBJíeHEE. ( intermittend raandatory ventilation ) ~ θΤΟ BaSHHHnpouecc jyur οτβηκηηεη nauneHTa ot asTOMaTEuecKoro HCKyccTBOH·ΗΟΓΟ SHXaHHH Η ΙίρΗΜθΗΕΘΤΟΗ 0ÓHHH0 BO ΒρθΜΗ Mí HOCJie aCCHC-TEpOBaHHOrO IPPB (ECKyCCTBeHHOrO UHXaHEH npepHBECTHM H3ÓH-tohhhm λθβλθηεθμ) . B Hauajie npouecca οτβηκηηηη uhkjih nps- - HyjíHTeJILHOrO ECKyCCTBeHHOrO SHXaBEH npOCnOCOÓJieHH COÓCTBeH-hoé EacTOTe ηηχηηηη nanzeHTa, ho- 3βτθμ HHTepBami Mesuy uhk-jiaMK npzHy-WeJiBHoro HCKyccTBeHHoro UHxaHEH ποοτθπθηηο yBe-JIHHHBaJOTCH, TaK HTO OTfleJIBHHe BEKJIH npEHyjJETeJIBHOrO HCKyc-cTBeHHoro UHXaHHH pa34e^HI0TCH Ο£ΗΞΜ Mí ΗΘΟΚΟΛΒΚΗΜΗ ΟΠΟΗΤΗΗ—ΗΗΜΗ ΒβΟΧΗΜΗ. B HpOUeCCe nporpeCCHpOBaHHH ΟΤΒΗΚΗΗΗΗ KOJDí—HeCTBO TaKHX CaMOCTOHTeJIBHHX BAOXOB yBSJEZHHBaeTCH, nOKa IÍHK-jm npEHyzEíTeJiEHoro HCKyccTBeHHoro ,κηχβηηη He οκη3ηβ&κ>τ nananneHTa ληιπβ He HMeKKjero 3ηηηθηεη ueScTBEH, nocjie uero na-DEeHTa ΜΟΗΗΟ OTMCHHTB OT aiHiapaTa HCBíyCCTBeHHOrO UHXaHHH,TaK KaK oh TenepB b coctohhhh uumaTB csMocTOHTeJiBHo, óe3nowpsKH. H3BECTHHX TEXHMBCKM ΡΕΜΒΗΝ H3BecrHH annapam jvih HCKyccTBeHHoro SHxaHKH, κοτορυθ sonos-HiíTejiLHo dtum nepeodopysoBaHH jyin HHTepMHTTnpyKsyero npHHysn-τθλβηογο SHxaHHH mm ημθιοτ ycrpožcTBO w βηποληθηηή ΗΗΤθρ-MHTTzpyícínero npHHysHTejiBHoro HCKyccTBeHHoro sHxaHHH (AHacTe-3hh, JIohsoh, 1977, tom 32, $ 2, οτρ. 163-169).TfeodpeTeHxe othochtch to ynpaBJíeHiro JW aBTOMaTHHecKEX Anna- • paTOB HCKyccTBeHHoro SHxaHHH c ynpaBJíeHHeM saBJíeHHH, HHrep- -BajiOB mu odteMOB Λ7ΙΗ nojínepKKBaeMoro h KOHTpojmpyeMoro HCKyccTBeHHoro ΚΗΧΗΗΗΗ, COCTOflmeMy H3 ΠΗΘΒΜΟ ΛΟΓΗΉβΟΚΗΧ-NEP-e KJwaTejiBHHX ynpaBJíHWix sJíeiaeHujOB what cxeMofl ynpaBJíeHEHftJIH HHTepMETTEpyE ^ ero npEHyíMTSJIBHOrO ECKyCCTBeHHOrO, ws-HHH (IMV), TO KOTOPOE ϋΟβΚΛΚΗβΗΗ Cpe ^ CTBa-M £ 03Hp0BKH 02,3aErKTH OT Ε30ΗΤ0ΗΗ0Γ0 SaBJíeHEH H KOMHHCCíHH JíaBJíeHEE. (Intermittend raandatory ventilation) ~ θΤΟ BaSHHHnpouecc jyur οτβηκηηεη nauneHTa rpm asTOMaTEuecKoro HCKyccTBOH · ΗΟΓΟ SHXaHHH Η ΙίρΗΜθΗΕΘΤΟΗ 0ÓHHH0 BO ΒρθΜΗ My HOCJie aCCHC-TEpOBaHHOrO IPPB (ECKyCCTBeHHOrO UHXaHEH npepHBECTHM H3ÓH-tohhhm λθβλθηεθμ). B Hauajie npouecca οτβηκηηηη uhkjih nps- - HyjíHTeJILHOrO ECKyCCTBeHHOrO SHXaBEH npOCnOCOÓJieHH COÓCTBeH-hoe EacTOTe ηηχηηηη nanzeHTa, HO- 3βτθμ HHTepBami MESU UHK-jiaMK npzHy-WeJiBHoro HCKyccTBeHHoro UHxaHEH ποοτθπθηηο YBE-JIHHHBaJOTCH and HTO OTfleJIBHHe BEKJIH npEHyjJETeJIBHOrO HCKyccTBeHHoro UHXaHHH PA34 ^ Ο HI0TCH £ ΗΞΜ Mí ΗΘΟΚΟΛΒΚΗΜΗ ΟΗΤΗΗΠΟΗΤΗΗ — ΗΗΜΗ ΒβΟΧΗΜΗ. B HpOUeCCe nporpeCCHpOBaHHH ΟΤΒΗΚΗΗΗΗ Kojda-HeCTBO TaKHX CaMOCTOHTeJIBHHX BAOXOB yBSJEZHHBaeTCH, Noka IÍHK-JM npEHyzEíTeJiEHoro HCKyccTBeHHoro, κηχβηηη He οκη3ηβ & κ> τ nananneHTa ληιπβ He HMeKKjero 3ηηηθηεη ueScTBEH, nocjie uero on-DEeHTa ΜΟΗΗΟ OTMCHHTB OT aiHiapaTa HCBíyCCTBeHHOrO UHXaHHH and KaK oh TenepB b coctohhhh uumaTB csMocTOHTeJiBHo, óe3nowpsKH. H3BECTHHX TEXHMBCKM ΡΕΜΒΗΝ H3BecrHH annapam jvih HCKyccTBeHHoro SHxaHKH, κοτορυθ Sonos-HiíTejiLHo dtum nepeodopysoBaHH jyin HHTepMHTTnpyKsyero npHHysn-τθλβηογο SHxaHHH mm ημθιοτ ycrpožcTBO w βηποληθηηή ΗΗΤθρ-MHTTzpyícínero npHHysHTejiBHoro HCKyccTBeHHoro sHxaHHH (AHacTe-3HH, JIohsoh 1977 about 32 $ 2 οτρ. 163 -169).
UpescTaBJLHeMoe ycrpočcTBO, κοτοροε sojixho ρθιπητβ npodseMyOTBHKaHZH OT ECKyCCTBeHHOrO jmxaHHH nos npepHBHCTHM H3ÓHT0H-HHM SaBJíeHHeM, ΚΜ6ΘΤ SOnOJIHHTeJILHO RpynOOÓfceMHyK) KOHCTpyKIXKD.ΠρΗΜβΗΗΘΜΗβ ΘΛΌΜΘΗΤΗ OTJHíHaiOTCH B OCOÓeHHOCTH pe3epByapOMnocTOHHHoro saBJíemLH, H3 κοτοροΓΟ nanseHT μοηθτ sumaTB hKoropufí HanojmaeTCH εεπήτθλβηημ ra30M pa3JiHHHoro cocTasa soypoBHB npesBapuTesBHO 3asaHHoro BHyTpsHHero saBJíeHzn h b jiio-doe BpeMH coxpaHHeT θτο saBJíeíme. . ycipoScTBO nosKZKjqeHO cooTBeTCTByKinHMH asaniepaMH κ oóhhho-My annapaTy jyra HCKyccTBeHHoro εηχθηηη, b κοτορκβ HanpaBJLH—eTcn sHxaTejibhhíí ra3 η κοτορκκ cooTBeTCTBywam: odBSMaMHbsoxh. nonasaeT b λιθγκηθ nanneHTa. K ycraHOBJíeHHOMy τβκημ0Ópa30M $yHKIBíOHaJIBHOMy y3Jiy OTHOCHTCH HeCKOJIBKO ΠΗΘΒΜΗΤΗ—qecKHX KJianaHOB, H3 κοτορκχ oshh λολχθη oóeenewTB Heod-xosHMoe nojiosETejiBHoe KOHenHoe BHSHxaTSJíBHoe saBJíeHne (PEEP)hjih nocTOBHHoe noJioJKHTesBHoe sasjíeHHe b siaxaTesBHOM nyTH(CPAP). IIpweHeHKe θτοε eme dojiee nospodno onEcaKHoS b λετθ-paType οηοτθμη socraraeT, npaBsa, Ε3μθηθηηογο οτηοοετθλβηοnpHHySHTeSBHOrO MHHyTHOrO OdseMa BSOXa (iot ) ypOBHH 0H-TepMHTTiipyiaiíero npnHysETesBHoro HCKyccTBeHHoro snxaHHH (IMV ),ho aimapaTHKe 3aTpaTH He nsyr he b Kasoe cpaBHeHze c αοοτεγ-HyTHM ΘφφθΚΤΟΜ. Η3ΒΘοτηη Tarase annapam sjih ECKyccTBeHHoro SHxaHHH c ynpas-.ηθηηθμ HHTepBajioB, κοτορηβ no noTpedHOCTH MoryT neperamoňaTBOHHa ynpaBJíeHHe saBseHHH π annapaTypa jyin οτβηκηηηη κοτορκχHa $a3e Bsoxa npHHysuTesBHoro saxanEH HapymaeT JsejiaTejiBHoenocTOHHCTBO xapaKTepHCTHKH EHTepBajioB, odseMa h saMemiH hUpescTaBJLHeMoe ycrpočcTBO, κοτοροε sojixho ρθιπητβ npodseMyOTBHKaHZH OT ECKyCCTBeHHOrO jmxaHHH nose npepHBHCTHM H3ÓHT0H HHM-SaBJíeHHeM, ΚΜ6ΘΤ SOnOJIHHTeJILHO RpynOOÓfceMHyK) KOHCTpyKIXKD.ΠρΗΜβΗΗΘΜΗβ ΘΛΌΜΘΗΤΗ OTJHíHaiOTCH B OCOÓeHHOCTH pe3epByapOMnocTOHHHoro saBJíemLH H3 κοτοροΓΟ nanseHT μοηθτ sumaTB hKoropufí HanojmaeTCH εεπήτθλβηημ ra30M pa3JiHHHoro cocTasa soypoBHB npesBapuTesBHO 3asaHHoro BHyTpsHHero saBJíeHzn HB jiio- doe BpeMH coxpaHHeT θτο saBJíeeme. . ycipoScTBO nosKZKjqeHO cooTBeTCTByKinHMH asaniepaMH κ oóhhho-My annapaTy jyra HCKyccTBeHHoro εηχθηηη, b κοτορκβ HanpaBJLH — eTcn sHxaTejibhhíí ra3 η κοτορκκ cooTBeTCTBywam: odBSMaMHbsoxh. nonasaeT b λιθγκηθ nanneHTα. The ycraHOBJíeHHOMy τβκημ0Ópa30M $ yHKIBíOHaJIBHOMy y3Jiy OTHOCHTCH HeCKOJIBKO ΠΗΘΒΜΗΤΗ-qecKHX KJianaHOB, H3 κοτορκχ oshh λολχθη oóeenewTB HEOD-xosHMoe nojiosETejiBHoe KOHenHoe BHSHxaTSJíBHoe saBJíeHne (PEEP) hjih nocTOBHHoe noJioJKHTesBHoe sasjíeHHe b siaxaTesBHOM nyTH (CPAP). IIpweHeHKe θτοε EME dojiee nospodno onEcaKHoS b λετθ-paType οηοτθμη socraraeT, npaBsa, Ε3μθηθηηογο οτηοοετθλβηοnpHHySHTeSBHOrO MHHyTHOrO OdseMa BSOXa (IOT) ypOBHH 0H-TepMHTTiipyiaiíero npnHysETesBHoro HCKyccTBeHHoro snxaHHH (IMV), it aimapaTHKe 3aTpaTH nsyr Ile Phe cpaBHeHze slurry b-c αοοτεγ Hythe ΘφφθΚΤΟΜ. Η3ΒΘοτηη Taras annapam sjih ECKyccTBeHHoro SHxaHHH c ynpas-.ηθηηθμ HHTepBajioB, but κοτορηβ noTpedHOCTH Ballad neperamoňaTBOHHa ynpaBJíeHHe saBseHHH π annapaTypa jyin οτβηκηηηη κοτορκχHa $ A3E Bsoxa npHHysuTesBHoro saxanEH HapymaeT JsejiaTejiBHoenocTOHHCTBO xapaKTepHCTHKH EHTepBajioB, odseMa h h saMemiH
TpeÓyeT noaTOMy κορρεκτζροΒΚΗ. HpuMepoM annapaTOB TaKoropOfla HBJLHeTCH CTaBIIlHt H3BeCTHHM HOS Η33Β3ΗΗβΜ "yHHBepcaJIL·-BeHTHJiHTop I" annapaT jyin λκκτθλβηογο εόκυόοτβθηηογο ,τππτΑπκπ(npocneKT 5662.1 φηρΜυ JlparepBepK AT, JtoóeK, híohb 1978 rosa),c noMomtio κοτοροΓο homhmo KOHTpojrapoBaHHoro h nossep&HBae-ΜΟΓΟ HCKyCCTBeHHOrO SHXaHHH, B03M0SCH0 TaK&e HHTepMHTTHpyKmeenpjraywejiBHoe HCKyccTBeHHoe SHxaHne ( my ). C nepemime-HneM Ha imv nacTOTa, 3aJioseHHaa b ocHOBy KOHTpozHpoBaHHoroHCKyCCTBeHHOrO SHXaHHH HJEH B OCHOBy ΠΟ£ΚθρΗΗΒΗΘΜΟΓΟ HCKyCCTBSHΗΟΓΟ SHXaHHH, SeJIHTCH CHanaJia Ha S6CHTB Η, ΚρΟΜΘ ΤΟΓΟ, ΗθΠΟΟ-pexcTBeHHO BpyaHy» ycTaHaBJíHBaeTCH nposoJioTejiBHocTB Bsoxanpz MexaHH3HpoBaHH0M xose Mexa aimapaTa CKyccTBeHHoro sHxa-hhh. OcrasBHoe BpeMH - sto nepepHBH, Korsa nanneHTy pa3pe-maeTCH οποητηηηοθ saxanne. Η πρη τβκομ peniem® b peayjiLTaTeyCTaHOBKH ΠΟΗΟΗΗΤβΗΒΗΟΓΟ ΚΟΗΘΗΗΟΓΟ SaBJíeHXH BHSOXa B03M0JKH0SHXaHHe npH HOCTOHHHOM ΠΟΗΟίΚΗΤΘΗΒΗΟΜ £8ΒΛΘΗΗΗ'Β SHXaTeSBHOMnyra. \ OSHaKO, npH THKOM ρβΚΗΜΘ paÓOTH ΗΘΗ30βΚΗΗ KOppeKTHpOBKH BseJiHx oóeójieneHHH HanajiBHoro oó^eMa Bsoxa nocJie nepexosa HaMexaHH3npoBaHHnt xos Mexa annapara. Η3βθοτηηθ annapaTH sjihHCKyCCTBeHHOrO SHXaHHH C SOHOJIHHTeJIBHOg B03M0KH0CTLD ΗΗΤβρ-MHTTupyícmero npHHysHrejiBHoro HCKyccTBeHHoro SHxaHHH paccan-THHH Ha CHHXp0HH3Hp0BaHH0e Dí? (s BÍV )» ©E3H0JI0rHHeCK0ehkoóh, npeiiMymecTBO κοτοροΓο, osHano, HenpneMJieMO. Βο-nepBHX, narseHT b $a3e οτβηκηηζη ηθοποκοθη, ;BO-Bropux,yze no3TOMy aacTOTa οποητθηηογο Bsoxa pesKaa Ha πηκθ npHHy-SHTeJiBHoro Bsoxa. Ecjih τθκοη cjiynan h εμθθτ Mecro, to Torsa3T0 oTBenaeT "B3SHxaHHio", noHBJíemíe κοτοροΓο thk hjih HHaneΗΒΛΗβΤΟΗ OCHOBHHM Τρβ00Β3ΗΖΘΜ npH KOHTpOJIHpOBaHHOM ZCKyCCTBeH-ΞΟΜ SHXaHHH.TpeÓyeT noaTOMy κορρεκτζροΒΚΗ. HpuMepoM annapaTOB TaKoropOfla HBJLHeTCH CTaBIIlHt H3BeCTHHM HOS Η33Β3ΗΗβΜ "yHHBepcaJIL · -BeHTHJiHTop I" annapaT jyin λκκτθλβηογο εόκυόοτβθηηογο, τππτΑπκπ (npocneKT 5662.1 φηρΜυ JlparepBepK AT JtoóeK, híohb 1978 rosa), c noMomtio κοτοροΓο homhmo KOHTpojrapoBaHHoro h nossep & HBae-ΜΟΓΟ HCKyCCTBeHHOrO SHXaHHH, B03M0SCH0 TaK & HHTepMHTTHpyKmeenpjraywejiBHoe HCKyccTBeHHoe SHxaHne (my). C-nepemime move nacTOTa IMV Ha, b 3aJioseHHaa ocHOBy KOHTpozHpoBaHHoroHCKyCCTBeHHOrO SHXaHHH HJEH B OCHOBy ΠΟ £ ΚθρΗΗΒΗΘΜΟΓΟ HCKyCCTBSHΗΟΓΟ SHXaHHH, SeJIHTCH CHanaJia Ha S6CHTB Η, ΚρΟΜΘ ΤΟΓΟ, ΗθΠΟΟ-pexcTBeHHO BpyaHy »ycTaHaBJíHBaeTCH nposoJioTejiBHocTB Bsoxanpz MexaHH3HpoBaHH0M xose Mexa aimapaTa CKyccTBeHHoro sHxa-HHH. OcrasBHoe BpeMH - sto nepepHBH, Korsa nanneHTy pa3pe-maeTCH οποητηηηοθ saxanne. Eni πρη τβκομ peniem® b peayjiLTaTeyCTaHOBKH ΠΟΗΟΗΗΤβΗΒΗΟΓΟ ΚΟΗΘΗΗΟΓΟ SaBJíeHXH BHSOXa B03M0JKH0SHXaHHe npH HOCTOHHHOM ΠΟΗΟίΚΗΤΘΗΒΗΟΜ £ 8ΒΛΘΗΗΗ'Β SHXaTeSBHOMnyra. OSHaKO, npH THKOM ρβΚΗΜΘ paÓOTH ΗΘΗ30βΚΗΗ KOppeKTHpOBKH BseJiHx oóeójieneHHH HanajiBHoro oó ^ eMa Bsoxa nocJie nepexosa HaMexaHH3npoBaHHnt xos Mexa annapara. 033βθοτηηθ annapaTH sjihHCKyCCTBeHHOrO SHXaHHH C SOHOJIHHTeJIBHOg B03M0KH0CTLD? (with BÍV) »© E3H0JI0rHHeCK0ehkoóh, npeiiMymecTBO κοτοροΓο, osHano, HenpneMJieMO. -Ο-nepBHX, narseHT b $ a3e οτβηκηηζη ηθοποκοθη,; BO-Bropux, yze no3TOMy aacTOTa οποητθηηογο Bsoxa pesKaa Ha πηκθ npHHy-SHTeJiBHoro Bsoxa. J τ ec ec ec ec ec ec ec ec ec ec ec ec ec ec ec ec ec ec ec H H H H H H H H H CH X X X X X X SHXaHHH
UezB HSoópereHHH 3aKjncmaeTCH b ycTpaHeHzz H3Jio&eHHHX BHmeHesocraTKOB, npzneM npz nocTanoBKe 3asaHZH co3HaTejiLHo orná-3aJIHCB OT B03M0KH0CTH 0ΖΗΧρ0ΗΗ3Ζρ0Β3ΗΗ0Γ0 W Η3ΟΕΡΕΤΈΗ03 B οοηοβυ H30ÓpeTeHHH 3ajE0&eHa sahana no yjiyzineHHio HMeromerocnb annaparax jw zcKyccTBeHHoro OTxaHHH βοποληητθλβηογο pesz-Ma paÓOTH HHTepMHTTHpyifflUerO npZHy£ZTeni>HOro HCKyCCTBeHHOrOíHxaHHH b tom CMecjie, ζτο Heotíxo£HMaH iw 3ΤΟΓΟ cxeMa ynpaB-JieHZH ΠρΖ MaKCZMaJIBHO B03M0HH0M ZCn0JIB30BaHZZ yze ΖΜΘΏΙφΙΧΟΗπηθβμο—λογζήθοκηχ nepeKWiawix z ynpaBJímanzx θλθμθητοβ no3-bojihst ocymecTBJíHTB Kaz MY, a πρζ Hajnnizz KzanaHa ^jih oó-pa30BaHHH ΡΟΒΗΟΓΟ ypOBHH ΠΟΖΟΖΖΤεΰΙΒΗΟΓΟ flaBJíeHZH B ΚΟΗΒ.Θ(PEEP) cnoHTaHHoe nuxaHze c coxpaHeHHeM ποοτοηηηογο hojio-ZHTejiLHoro naBJíeHZH b íHxaTejiBHHx nyrnx (CPAP), TaK z on-τημηζβηο peryjrupyeT sproHOMzio b cbh3z Mesny πθιχηθητομ z an-napaTOM jyin zcKyccTBeHHoro κηχηηζη c πομοπιβιο tojibko onnoro^onojiHiíTejiBHoro nepeKJiKnaKHnero z czraajiz3zpyioii[ero 3JieMeHTa.UezB HSoópereHHH 3aKjncmaeTCH b ycTpaHeHzz H3Jio & eHHHX BHmeHesocraTKOB, npzneM HPH nocTanoBKe 3asaHZH co3HaTejiLHo arable-3aJIHCB OT B03M0KH0CTH 0ΖΗΧρ0ΗΗ3Ζρ0Β3ΗΗ0Γ0 W Η3ΟΕΡΕΤΈΗ03 B οοηοβυ H30ÓpeTeHHH 3ajE0 & EHA Sahana well yjiyzineHHio HMeromerocnb annaparax JW zcKyccTBeHHoro OTxaHHH βοποληητθλβηογο pesz-Ma paÓOTH HHTepMHTTHpyifflUerO npZHy £ ZTeni> HOROU HCKyCCTBeHHOrOíHxaHHH b the CMecjie, ζτο Heotíxo £ HMaH iw 3ΤΟΓΟ cxeMa ynpaB-JieHZH ΠρΖ MaKCZMaJIBHO B03M0HH0M ZCn0JIB30BaHZZ yze ΖΜΘΏΙφΙΧΟΗπηθβμο-λογζήθοκηχ nepeKWiawix of ynpaBJímanzx θλθμθητοβ NO3-bojihst ocymecTBJíHTB Kaz MY and πρζ Hajnnizz KzanaHa ^ oO-south pa30BaHHH ΡΟΒΗΟΓΟ ypOBHH ΠΟΖΟΖΖΤεΰΙΒΗΟΓΟ flaBJíeHZH ΚΟΗΒ.Θ B ( PEEP) cnoHTaHHoe nuxaHze c coxpaHeHHeM ποοτοηηηογο hojio-ZHTejiLHoro naBJIeHZH b íHxaTejiBHHx nyrnx (CPAP), TaK z on-τημηζβηο peryjrupyeT sproHOMzio b cbh3z Mesny πθιχη θητομ z an-napaTOM jyin zcKyccTBeHHoro κηχηηζη c πομοπιβιο tojibko onnoro ^ onojiHiíTejiBHoro nepeKJiKnaKHnero z czraajiz3zpyioii [ero 3JieMeHTa.
H3JIQEEHHE CTOOCTH 03OEPETEM 3anaHne coiviacHO zsodpeTemro pemaeTCH τθμ, hto cxeMa ynpas-JieHzn wieeT jzonojiHZTejiBHoe ynpaBJíeHEe, cocToamee 03 nepeKJno-naTejiH po,n;a paóoT, ÓJiOKa "W'jí #Byx ójiokob ”0”, zto coοτοροΗΗ Bxona nepeKJnonaTejiB pona paóoT cBH3aH c jniHzez yn-paHJDwmero naBJíeHzz οηοτθμη ynpaajieHZH annapaTa zcKyccTBeH—ΗΟΓΟ SHXaHHH Z CO CTOpOHLI BHXOSa C O&K0M 03 BXOSOB ÓJIOKa”0ΗΗ" η ózokob "M", 0 zto Ójiok ”0H0” z ójiok ”0" zepe3 nxBToptie bxojíh ποηκησζεΗΗ κ nenz czrHaJL03az0z MexaHZ3Ma ynpaB-jieHzz EaBJíeHzeM, HHTepBaxaMH 0 ο0βθμομ οζοτθμη ynpaBJíeHZHannapaTa jyin zcKyccTBeHHoro jmxaHza, a zepe3 zx bhxojíh kMHoroxojíOBOMy KJianany, zMenneMy cbh3B c .τεηηθε ynpaBJíeHZHsaBJteHHeM, κ nepeKjnozaTejno noporoBHX 3HazeHzS 0 κ KOMÓHHa-ixhh Z3 oópaTHoro z ΜΗΟΓοχοβΟΒΟΓΟ KJianaHa, KOTOpne, B CBODonepeflB, CBH3aHH c Y-oópa3HHM θλθμθητομ y noMJHozeHzn nanz-eHTa zepe3 H3Bec.THHe nepeKjnzzawie 0 ynpaBJízwíe sjismohth. KJiarCWpH Η300ρθΤΘΗΙΏΟ ίξΟΟΤΕΤΗΘΤΟΗ UpeBOCXOtfCTBO SW , κοτοροθ nojiHOCTbio npoíiBJíHeTCH ksk npoďoe pemeHne npn npo-TeKajQiqeM sTanawH npopecce οτβηκθηιίη. HcxoflHofi tohkoh nponeccaOTBHKaHHH ηβεηθτοη b oóiuew HCKyccTBeHHoe joax&HHG nos nepe-flyWMCfl HsteoHHHM εθβηθηηθμ (IPPE). 3aTeM cjie^yeT nojyrep-&HBaeMoe HCKyccTBeHHoe jwaHHe nos HepepyioiqHMCH £8&τιθηηθμnpn hhskoh ^yBCTBHTeJiLHOCTK τρι-írrepa h yjyoiHeHHKx nepepHBax,HaKOHeií. cjie^yer nepemnonemie Ha w c ncnojn>3OBaHHeM BcexTexHHHecKHX cpe^cTB npHHyjrHTejiBHoro accHCTnpoBaHHoro HCKyc—οτβθηηογο XHxaHKH b cjiynae oTcyrcTBHH ποπητκη naujieHTa £h-niaTB caMocTOHTeJiLHo nocjie nepeptma. npent-ryinecrBo ocodeHHOnpoHBJLHeTCH na nocJiesHeM 3Tane, τβκ κηκ 3nect> upohcxcottΧΟΉ HpHHyjXHTejIBHOrO HCKyCCTBSHHOrr SHXaHKH C yCTaHOBKOtHa accHCTHpyMiíee HCKyccTBeHHoe jmxaHne mm c ójiokhpobkokTpmrepa, a b ΗΜβιοπίθΜοπ na stom 3Tane nepeptme nanneHT mo-seT ffinnaiL οποητβηηο.H3JIQEEHHE CTOOCTH 03OEPETEM 3anaHne coiviacHO zsodpeTemro pemaeTCH τθμ, HTO cxeMa ynpas-JieHzn wieeT jzonojiHZTejiBHoe ynpaBJíeHEe, cocToamee 03 nepeKJno naTejiH after-n, and paóoT, ÓJiOKa "W'jí #Byx ójiokob" 0 "ZTO coοτοροΗΗ Bxona nepeKJnonaTejiB pona paóoT cBH3aH C jniHzez yn-paHJDwmero naBJíeHzz οηοτθμη ynpaajieHZH annapaTa zcKyccTBeH-ΗΟΓΟ SHXaHHH CO CTOpOHLI BHXOSa C & K0M 03 BXOSOB ÓJIOKa "0ΗΗ" η ózokob "M" 0 ZTO ójiok "0H0" from ójiok "0" zepe3 nxBToptie bxojíh ποηκησζεΗΗ κ Nenzi czrHaJL03az0z MexaHZ3Ma ynpaB-jieHzz EaBJíeHzeM, HHTepBaxaMH 0 ο0βθμομ οζοτθμη ynpaBJíeHZHannapaTa jyin zcKyccTBeHHoro jmxaHza and zepe3 ZX bhxojíh kMHoroxojíOBOMy KJianany, zMenneMy cbh3B .τεηηθε ynpaBJíeHZHsaBJteHHeM c, κ nepeKjnozaTejno noporoBHX 3HazeHzS 0 κ-KOMÓHHa ixhh Z3 oópaTHoro of ΜΗΟΓοχοβΟΒΟΓΟ KJianaHa, KOTOpne B CBODonepeflB, CBH3aHH c Y-oópa3HHM θλθμθητομ y noMJHozeHzn nanz-eHTa zepe3 H3Bec.THHe nepeKjnzzawie 0 ynpaBJizwíe sjismohth. KJiarCWpH Η300ρθΤΘΗΙΏΟ ίξΟΟΤΕΤΗΘΤΟΗ UpeBOCXOtfCTBO SW, κοτOCρOCOCOCOCOCOCOCOC OCOCOCOCOCanaanaHHHTTTTTTTTTTTTTTTskskskskskanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaanaana HcxoflHofi tohkoh nponeccaOTBHKaHHH ηβεηθτοη b oóiuew HCKyccTBeHHoe joax & HHG nose nepe-flyWMCfl HsteoHHHM εθβηθηηθμ (IPPE). 3aTeM cjie ^ yeT nojyrep- & HBaeMoe HCKyccTBeHHoe jwaHHe nos HepepyioiqHMCH £ 8 & cjie ^ yer nepemnonemie Ha w c nnnnn> 3OBaHHeM BcexTexHHHecKHX cpe ^ cTB npHHyjrHTejiBHoro accHCTnpoBaHHoro HCKyc — XHxaHKH b cjiynae oTcyrcTBHH ποπητκη naujieHTa £ h-niaTB caMocTOHTeJiLHo nocjie nepeptma. npent-ryinecrBo ocodeHHOnpoHBJLHeTCH to nocJiesHeM 3Tane, τβκ κηκ 3nect> upohcxcottΧΟΉ HpHHyjXHTejIBHOrO HCKyCCTBSHHOrr SHXaHKH C yCTaHOBKOtHa accHCTHpyMiíee HCKyccTBeHHoe jmxaHne mm ójiokhpobkokTpmrepa c, b and a stoma ΗΜβιοπίθΜοπ 3Tane nonpeptide nanneHT MO-set ffinnaiL οποητβηηο.
Ilepeptm mozho nocjiesoBaTeJiBHO npoxyieBaTB c nporpeccnpywrMOTBHKaHEteM naiWHTa. IIpemioHTHTejiBHo nepeKJuoHaTejiL posapaóoT HMeeT 3/2 čyHKujm h CBH3aH co ctopohh Bxosa c npoxo-jwsh κ nosmnoHemno Og JDíHnefí ynpa&TieHHH saBJíeHneM, CECTe-mh ynpaBJíeHHH aimapaTOM juk HCKyccTBeHHoro jmxaHEH, a coCTOpOHH BHXOSa - Ήθρθ3 HpHMOÍI CTaTHHeCKEfl BXO£ C ÓJLOKOM"ffl", a Taiose nepe3 KasjZHfi εηβθροηοηηηε cTaTEnecKEil bxojí -C nepBHM ÓJIOKOM ΠΙΓ E CO BTODHM ÓJIOKOM ”H”.Ilepeptm mozo nocjiesoBaTeJiBHO npoxyieBaTB c nporpeccnpywrMOTBHKaHEteM naiWHTa. IIpemioHTHTejiBHo nepeKJuoHaTejiL posapaóoT HMeeT 2.3 čyHKujm h CBH3aH what ctopohh Bxosa c npoxo-jwsh κ nosmnoHemno Og JDíHnefí ynpa & TieHHH saBJíeHneM, CECT-MH ynpaBJíeHHH aimapaTOM Juk HCKyccTBeHHoro jmxaHEH and coCTOpOHH BHXOSa - Ήθρθ3 HpHMOÍI CTaTHHeCKEfl BXO £ C ÓJLOKOM "ffl" and Taiose nepe3 KasjZHfi εηβθροηοηηηε cTaTEnecKEil bxojí -C nepBHM ÓJIOKOM ΠΙΓ E CO BTODHM ÓJIOKOM ”H”.
ΠρΗΜΘΗΗΘΜΗθ B JTOHOJEHET eJIBHOM ynpaBJíeHEE E 0ΒΗ33ΗΗΗβ C HHM nepemnonawie π ynpaBJíHHnae θλθμθητη ηθ hrehiotch csme noceóe nacTBio Ε3θόρθΤθΗΗΗ, τ&κ ητο ohe ηθ οπεοηβηκτοη 3secBóojiee no^podHo. BapnaHT E30ÓpereHEH, ojmano, no nejieBOMyHa3HaneHino oTjnmaeTCH τθμ, ήτο π operníma? θεβ noporoBux na-paMeTpOB ΗΜΘβΤ CBH3B C 3ΛΘΜΘΗΤ0Μ ΠΟίΗϋϊΊΟΗΘΗΕΗ ΠΗΗΗθΗΤΒ, KO-TOpHE C ΟΛΗΟΗ CTOpOHH, Ήβρθ3 KJianaH PEEP/CPAP C CBH3aHHHĚc hhm BHjwaTejiLHHn rnianan nojnmsneH κ cncreMe ynpamieHEHannapaTa jw HCKyccTBeHHoro zmxaHHH, e, c npyroH ctopohh, ..κοκ κ rnianany jym 3aiwn οτ ε30ητοηηογο α^μθηεη η k Kam- jieBOMy KJianaHy, tsk z k zHHSKTopy, 0BH3aHH0My c nporozHWiKJianaHOM z μηογοχολοβημ KJiananoM; hto KOMóHHaixzz Z3 oópaT-ηογο z μηογοχολοβογο KJianaHOB, KOTopan zepe3 ojjih χολ cbh-3aHa c KaiímeBHM KJianaHOM z bosjqtciihum φ&ΗΒτροΜ, a zepe3 ^py~ΓΟΚ ΧΟΛ - BO-nepBHX npz npOMeJKyTO^IHOM ΠΟΛΚΗΚΉβΗΖΗ ΛΟΠΟΛΉΗ—τώίΒΗΟΓΟ ΠΡΟΤΟΉΗΟΓΟ KJianaHa Ζ ρΒΟΧΟΛΟΜερδ C SJíeweHTOM ΒΟΛ-KJHozeHHH Og, a Βο-Βτορκχ, c ypaBHZTejitHHM cocyΛOM z imana-ΗΟΜ ΛΛΗ 3aUÍKTH OT Ζ30ΗΤ0ΖΗ0Γ0 ΛδΒΗβΗΗΗ npz ΠΟΛΗΉΘ Og.βοποΛΗΗΤΒΛΒΗΟδ ynpaBJíeHze ynoóHo noMe^aeTcn b jimóom annapa-Te jyiH zcKyccTBeHHoro ληχθηζη. Πρζ θτοΜ nepeKjncnaTejiB ροΛδpaóoT, ójiok "W z Ójiok "H” cocTaBJímoT οληη yeeji z κομπβκτ—HO CBH3aHEI ΜΘΧΛ7 COÓOZ. ΪΛΟ0ΟΤΒΟ 3aKJH0ZaeTCH eine B TOM, HTOπροτοζΗΗβ KJiananH, nepeicjnonaTejiL noporoBHX 3HaneHzz, KJianazPEEP/CPAP z ΒοτροθΗΗϋζ bójiz3z nanzeHTa KJianaH jw 3amzTHOT Ζ30ΗΤ0ΖΗ0Γ0 λ&βλθηζζ mokho peryjizpoBaTB.ΒΗ ΗΗΗ B ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ ΒΗ C C C C C C C C C C C C C C C C C C C C C C C C 3.. BapnaHT E30ÓpereHEH, ojmano, no nejieBOMyHa3HaneHino oTjnmaeTCH τèμ, ήτο π oper. θεβ noporoBux on-paMeTpOB ΗΜΘβΤ CBH3B C 3ΛΘΜΘΗΤ0Μ ΠΟίΗϋϊΊΟΗΘΗΕΗ ΠΗΗΗθΗΤΒ co-tophat C ΟΛΗΟΗ CTOpOHH, Ήβρθ3 KJianaH PEEP / CPAP C CBH3aHHHĚc HHM BHjwaTejiLHHn rnianan nojnmsneH κ cncreMe ynpamieHEHannapaTa JW HCKyccTBeHHoro zmxaHHH, E, C npyroH ctopohh, ..κοκ κ rnianany jym 3aiwn οτ ε30ητοηηογο α ^ μθηεη η k KamieBOMy KJianaHy, tsk zk zHHSKTopy, 0BH3aHH0My c nporozHWiKJianaHOM z μηογοχολοβημ KJiananoM; hto KOMóHHaixzz Z3 oópaT-ηογο of μηογοχολοβογο KJianaHOB, KOTopan zepe3 ojjih χολ CBH-3aHa c KaiímeBHM KJianaHOM of bosjqtciihum φ & ΗΒτροΜ and zepe3 ^ py ~ ΓΟΚ ΧΟΛ - BO nepBHX HPH npOMeJKyTO ^ ihome ΠΟΛΚΗΚΉβΗΖΗ ΛΟΠΟΛΉΗ-τώίΒΗΟΓΟ ΠΡΟΤΟΉΗΟΓΟ KJianaHa Ζ ρΒΟΧΟΛΟΜερδ C SJíeweHTOM ΒΟΛ-KJHozeHHH Og and Βο Βτορκχ-c ypaBHZTejitHHM cocyΛOM of Iman-ΗΟΜ ΛΛΗ 3aUÍKTH OT Ζ30ΗΤ0ΖΗ0Γ0 ΛδΒΗβΗΗΗ HPH ΠΟΛΗΉΘ Og.βοποΛΗΗΤΒΛΒΗΟδ ynpaBJíeHze ynoóHo Nome aeTcn ^ b jimóom annapa-Te jyiH zcKyccTBeHHoro ληχθηζη. Πρζ θτοΜ nepeKjncnaTejiB ροΛδpaóoT, ójiok "W z Ójok" H "cocTaBJímoT οληη yeeji z κομπβκτ — HO CBH3aHEI ΜΘΧΛ7 COÓOZ. OM0ΟΤΒΟ 3aKJH0ZaeTCH eine B TOM, HTOπροτοζΗΗβ KJiananH, neeicjnonaTejiL noporoBHX 3HaneHzz, KJianazPEEP / CPAP of τοτροθΗΗϋζ bójiz3z nanzeHTa KJianaH jw 3amzTHOT Ζ30ΗΤ0ΖΗ0Γ0 λ &
KpoMe Toro, B03M0KH0 eme πpeΛycMOτpeτB cooTBeTCTByioiitzz Me-XaHZ3M Λ^Η ΟΒΘΤΟΒΟβ ZJIH 3ByK0B0Tí CZTHaJIZ3aHKZ, CpaÓaTUBaiO-mez npz njy z czrHarz3zpyiQiqzž npzHynzT6JiBHoe zcKyccTBOH—Hoe,λμχβηζθ nocjie οημοοτοητθλβηογο ληχηηζη nanzeHTa b nepe-ptmax. ycTpožCTBa Tazoro ροΛη, οληηκο, ζ3βθοτηη z nosTOMy3ΛθΟΒ ΗΘ OUZCHBaiOTCZ ÓOJiee ΠΟΛροόΗΟ. ΠΡΙ4ΜΕΡ OCWCTBJEEM Η30ΕΡΕΊΈΜKpoMe Toro B03M0KH0 EME πpeΛycMOτpeτB cooTBeTCTByioiitzz Me-XaHZ3M Λ ^ Η ΟΒΘΤΟΒΟβ ZJIH 3ByK0B0Tí CZTHaJIZ3aHKZ, CpaÓaTUBaiO-bound NEP njy of czrHarz3zpyiQiqzž npzHynzT6JiBHoe zcKyccTBOH-Hoe, λμχβηζθ nocjie οημοοτοητθλβηογο ληχηηζη nanzeHTa b NEP-ptmax. ycTpožCTBa Tazoro ροΛη, οληηκο, ζ3βθοτηη z nosTOMy3ΛθΟΒ ΗΘ OUZCHBaiOTCZ ÓOJiee ΠΟΛροόΗΟ. ΠΡΙ4ΜΕΡ OCWCTBJEEM Η30ΕΡΕΊΈΜ
HpzMep ocyiqecTKTieHHZ z3oópeTeHzn Hzse onzcHBaeTCH óoJiee πολ-poÓHO co cchjikož Ha npzjiaraeMHz zepTes, na κοτοροΜ noKa3a-Ha, corjracHo z3oópeTeHzio, cxeMa λοποληζτο-ίβηογο ynpaBJíeHznz KOMnoHOBKa cxeMH c ynpaBJíeHzeM annapaTOM jw zcKyccTBSH-Horo ληχηηζη. H30ÓpazeHHEZ na zeprese annapaT jyia zcKyccTBesΗΟΓΟ ΛΗΧΘΗΖΗ COCTOZT Z3 ΠΟΜΘΗΘΗΗΟΓΟ II03ZHZeS I ycTpožCTBaynpaBJíeHZH annapaTOM, μθχηηζ3Μ ynpaBJíeHzn λ&βηθηζη, oóseMaz ZHTepBajioB κοτοροηο npz noAUepszBaeMOM z KOHTpoJizpyeMOMZCKyCCTBeHHOM ΛΗΧ21ΗΗΖ BOOÓIHe-TO Ζ3ΒΘ0Τ6Η Z HOSTOMy ΗΘ ΟΠΗ-CHBaeTCH 3ΛθθΒ óojiee πολρο0ηο. C ηημ οβη3ηηο πρθληβ33βήθηηοθΛΛΗ λοπο^ιηζτθλβηογο penzma padoTH npz HHTepMZTTzpyícqeM npz-HpzMep ocyiqecTKTieHHZ z3oópeTeHzn Hzse onzcHBaeTCH óoJiee πολ-Pooh what cchjikož Ha npzjiaraeMHz zepTes to κοτοροΜ noKa3a-Ha corjracHo z3oópeTeHzio, cxeMa λοποληζτο-ίβηογο ynpaBJíeHznz KOMnoHOBKa cxeMH c ynpaBJíeHzeM annapaTOM JW zcKyccTBSH-Horo ληχηηζη. H30ÓpazeHHEZ to zeprese annapaT jyia zcKyccTBesΗΟΓΟ ΛΗΧΘΗΖΗ COCTOZT Z3 ΠΟΜΘΗΘΗΗΟΓΟ II03ZHZeS I ycTpožCTBaynpaBJíeHZH annapaTOM, μθχηηζ3Μ ynpaBJíeHzn λ & βηθηζη, oóseMaz ZHTepBajioB κοτοροηο HPH noAUepszBaeMOM of KOHTpoJizpyeMOMZCKyCCTBeHHOM ΛΗΧ21ΗΗΖ BOOÓIHe-TO Ζ3ΒΘ0Τ6Η Z HOSTOMy ΗΘ ΟΠΗ-CHBaeTCH 3ΛθθΒ óojiee πολρο0ηο. C ηημ οβη3ηηο πρθληβ33βήθηηοθ λοπο ^ ιηζτθλβηογο padoTH npz HHTepMZTTzpyícqeM npz-
HyflKTeJILHOM HCKyCCTBeHHOM £ΗΧ3ΗΕΗ ΕΟΠΟΧΗΕΤβΛΒΗΟΘ yCTpOHCTBOynpasjíeHHH 2, ochobhok y3eji κοτοροΓο coctoht 23 nepeiuiKna-τθΛΗ po^a padoT 3, ο,ίχηογο ÓJioKa "W 4 h EByx ójiokob "Ef”HyflKTeJILHOM HCKyCCTBeHHOM £ ΗΧ3ΗΕΗ ΕΟΠΟΧΗΕΤβΛΒΗΟΘ yCTpOHCTBOynpasjíeHHH 2, ochobhok y3eji κοτοροΓο coctoht 23 nepeiuiKna-τθΛΗ po ^ a padoT 3, ίχηογο ÓJioKa "W 4h EByx ójiokob" Ef "
5, 6. BsnoJiHBnííHg 3/2 $yHKiw nepeKJiKHaTejiL· posa padoT 3CO CTOpOHH BXOJia COeSHHeH C ΧΗΗΗΘΙί ynpaBJíeHKfl ΛΠΒΧβΗΕβΜ 8ynpaBJíeHKH annapara I, npoxojpimeft κ 3a^2My nojrmuoHeHHH 02 7,a co CTopoHH BHKO^a - nepe3 npm/iofi οτβτκηθοκηΑ bxos c dxo-kom "KHH” 4, a ranse aeps3 κηκπκη odpaTHHfí cTaTHHecKEH bxoac nepBHM ójiokom ”H" 5 2 btophm ójiokom "H” 6. ípyrae bxothÓJIOKa 4 2 ÓJIOKOB ”M” 5, 6 CBH3aHH C JIKHHeH CHrHaJIH3aiW 9 MexaHE3Ma ynpaBJíeHHH flaBJíeHHeM, odiCMOM h EHTcpBaJiaMH chc-τθμη ynpaBJíeHKH annapaioM jw ECKyccTBSHHoro αηχθηηη I. ΒκχοπÓJioKa ”KJIH" 4 πο^κλκηθη k MHoroxojioBOMy EJianany 10, bhxosÓJioKa ”H” 5 πο,πκοηθη κ nepeKJimaTejro πορογοβηχ 3Ηβήθηηε IIh bhxos óxoKa "K" 6 κ KOMÓEHaiíHH K3 odpaTHoro X ΜΗΟΓΟΧΟβΟΒΟ-ro KxanaHOB 12. JIhhhh 13 cosjchhhct nepeKJHOHaTejiB πορογοβηχ3Ha^eHHx II c y-odpa3HNM aneMeHTOM y ποτζοιοΗβΗΗΗ naipieHTa 15KOTOpuft c OJXHOH CTOpOHH, ΠΟΑΚΖΒΟΗΘΗ nepe3 KJianaH PEEP/GPAP 16η οβηβηηηηη c hzm βηχβτ ejibhhS KJianaH .. 17 κ ynp.aBJíeHHio anna-paTOM HCKyccTBeHHoro HHxaHHH I e, c jipyroii ctopohh, KaK :...knpejíoxpaHHrejiLHOMy KJianaHy 18 h KanuieBOMy KxanaHy 19, ran2 κ EKseKTopy 21, coe£KHeHHOMy c προτοηηημ KJiananoM 20 h mho-γοχολοβημ imanaHOM 10. Βίκβκτορ 21 ημθθτ socTyn co ctopohhynpaBJweMoro MeMdpaHoS 3aTBopa κομ0εηηιχηη 23 odpainoro 2ΜΗΟΓΟΧΟβΟΒΟΓΟ KJianaHOB 12, KOTOpaH, Π0ΜΗΜ0 flOCTyna CO CTO-POHH ÓJioKa "Η" 6, ημθθτ £Ba ήοποχηετθλβηηχ οτ^θ^βηηχ ot ηθγοXOfla, 23 ΚΟΤΟρΗΧ 0>íH CBH3aH C Κ3132ΘΒΗΜ KJianaHOM 19 2 C B03-jiyinHHM φΗΛΒτροΜ 22, PacnoJioseHHHM b daxnace. ZpyroĚ xo# npo-xojíht npn npoMesyTOHHOM nofftunoHeHEE προτοπΗΟΓο KJianaHa 23 2pacxosoMepa 24 κ jiehhh 02 7, ho z k ypaBHETeJiLHOMy cocyay 252 npe_noxpaH2TeJiLHOMy KJianaHy 26.5, 6. BsnoJiHBnííHg $ 03.02 yHKiw nepeKJiKHaTejiL · posa padoT 3CO CTOpOHH BXOJia COeSHHeH C ΧΗΗΗΘΙί ynpaBJíeHKfl ΛΠΒΧβΗΕβΜ 8ynpaBJíeHKH annapara I npoxojpimeft κ 3aR 2My nojrmuoHeHHH 02 7, and most CTopoHH BHKO ^ and - nepe3 NPM / iofi οτβτκηθοκηΑ bxos c DXO "KHH" 4, and ranse aeps3 κηκπκη odpaTHHfí cTaTHHecKEH bxoac nepBHM ójiokom "H" 5 2 btophm ójiokom "H" 6. EHTcpBaJiaMH CHC-τθμη ynpaBJíeHKH annapaioM JW ECKyccTBSHHoro αηχθηηη I. ΒκχοπÓJioKa "southward" 4 ^ πο κλκηθη to MHoroxojioBOMy EJianany 10 bhxosÓJioKa "H" 5 πο, πκοηθη κ nepeKJimaTejro πορογοβηχ 3Ηβήθηηε IIh bhxos óxoKa "K" 6 κ KOMÓEHaiíHH K3 odpaTHoro X ΜΗΟΓΟΧΟβΟΒΟ- ro KxanaHOB 12. JIhhhh 13 cosjchhhct nepeKJHOHaTejiB πορογοβηχ3Ha ^ eHHx II c y-odpa3HNM aneMeHTOM y ποτζοιοΗβΗΗΗ naipie HTa 15KOTOpuft C OJXHOH CTOpOHH, ΠΟΑΚΖΒΟΗΘΗ nepe3 KJianaH PEEP / GPAP 16η οβηβηηηηη c hzm βηχβτ ejibhhS KJianaH .. 17 κ ynp.aBJíeHHio Anna-stressed HCKyccTBeHHoro HHxaHHH I e c jipyroii ctopohh, KaK ... knpejíoxpaHHrejiLHOMy KJianaHy 18h KanuieBOMy KxanaHy 19 , κ ran2 EKseKTopy 21 Coe £ KHeHHOMy c προτοηηημ KJiananoM 20h mho-γοχολοβημ imanaHOM 10th Βίκβκτορ 21 ημθθτ socTyn what ctopohhynpaBJweMoro MeMdpaHoS 3aTBopa κομ0εηηιχηη 23 odpainoro 2ΜΗΟΓΟΧΟβΟΒΟΓΟ KJianaHOB 12 KOTOpaH, Π0ΜΗΜ0 flOCTyna CO CTO-POHH ÓJioKa "Η" 6 ημθθτ Ba Ba Ba BH BH Ba Ba BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH BH. ZporoĚ xo # npo-xojíht npn npoMesyTOHHOM nofftunoHeHEE προτοπΗΟΓο KJianaHa 23 2pacxosoMepa 24 κ jiehhh 02 7, ho z k ypaBHETeJiLHOMy cocyay 252 npe_noxpaH2TeJiLHOMy KJianaHy 26.
Oshh nacTB HaxoíHmerocH no# saKTeHEew KECJiopona w ynpasjíe- hhh HanpaBJLHeTCH Hepe3 jihhed ynpa3JieH2H 8 b CEcreMy ynpas- jieHKH annapaTOM HCKyccTBeHHoro τηχβηηη I h b £onojiH2TeJiBHoe ycrpoECTBO ynpaBJíeHHH 2. Λογηηθοκηθ βχθμθητη cbh3h (b 4, 5Oshh nacTB HaxoíHmerocH NO # saKTeHEew KECJiopona w ynpasjíe- hhh HanpaBJLHeTCH Hepe3 jihhed ynpa3JieH2H 8 b CEcreMy ynpas- jieHKH annapaTOM HCKyccTBeHHoro τηχβηηη i h b £ onojiH2TeJiBHoe ycrpoECTBO ynpaBJíeHHH second Λογηηθοκηθ βχθμθητη cbh3h (b 4, 5
2 6), np2CnOCOdJieH2e ;Πρ023Β0ΛΠΤδ2ΒΗ00Τ2 ΚΟΤΟρΗΧ K nOC2e;oyní{HM 9JieMeHTaiw c ηρζΒΟβΟΜ csaTHM BO3^yxoM ocodeHHO djiarosapnΠρΕΜΘΗΘΗΖΙΟ H3B.3CTHHX peJie C JtBO&ÍOS MOMdpaHOE 2 ΚΟΤΟρΗθycTaHaBJUTBaior cbh3l MeatjQT ynpaBJíeHzeM annapaTa jyra zcKyc—CTBeHHoro jtHxaHKH I c βοποΛΓΗΗΤβΛΒΗϊΐΜ ynpaBJíeHzeM 2, pa3pa~ÓoTaHH Ha da3e EorznecKofí: onepaizzz "H" 2 W. lípu θτομÓJIOK "HJH” 4 ΒΗΠΟΕΗΗΘΤ φΤΗΚΙξΗΙΟ αη3ί>κηκιϊεη , z Ójiokh "H" 5, 6(SyHKiBro 3anpera, τθκ ητο οοοτβθτοτβοηηο npzHHTOMy pemeHEionepeKjnonaTeJLH pojía padoT 3 cooTBeTCTByioiííHM oópa3OM nepepa-daTHBaerca ΕΗφορΜθίζΐΗ b Buse bhxojíhhx οεγηθεοβ. Tanze czr-HajiH saBJíeHHH, odpa3ywreca b 3θβηοεμοοτη ot MexaHZ3Ma yn-paBJíeHHH EaBJíeHHeM-odteMOM zjie EHTepBajioM tvlh nojmepszBa-ΘΜΟΓΟ ZJIE KOHTpOJmpyeMOrO ZCKyCCTBeHHOrO EHXaHZH CHCTSMHynpaBJíeHHH annapaTa jyin zcKyccTBeHHoro ληχθηηη I, a TanneB 3aBZCEM0CTE OT Z3dpaHH0r0 £OnOJIHETeJII>HO:i?O peJEHMa padOTHHHTepMHTTHpyícmero npzHyAZTejiBHoro zcKyccTBeHHoro εηχηηζη,npeodpa30BHBaioTCH MeMdpazaMZ b ycajnra, κοτορκθ no3BOJiHK)THeodxoíHMoe nepeKJimeHze jdíhez.2 6) np2CnOCOdJieH2e; Πρ023Β0ΛΠΤδ2ΒΗ00Τ2 ΚΟΤΟρΗΧ K nOC2e; oyní {HM 9JieMeHTaiw c ηρζΒΟβΟΜ csaTHM BO3 ^ yxoM ocodeHHO djiarosapnΠρΕΜΘΗΘΗΖΙΟ H3B.3CTHHX sing C JtBO & IOS MOMdpaHOE 2 ΚΟΤΟρΗθycTaHaBJUTBaior cbh3l MeatjQT ynpaBJíeHzeM annapaTa jyra zcKyc-CTBeHHoro jtHxaHKH Ic βοποΛΓΗΗΤβΛΒΗϊΐΜ ynpaBJíeHzeM 2 pa3pa ~ Ha ÓoTaHH da3e EorznecKofí: onepaizzz "H" 2 W. θτομÓJIOK linden "HJH" 4 ΒΗΠΟΕΗΗΘΤ φΤΗΚΙξΗΙΟ αη3ί> κηκιϊεη of Ójiokh "H" 5, 6 (SyHKiBro 3anpera, τθκ ητο οοοτβθτοτβοηηο npzHHTOMy pemeHEionepeKjnonaTeJLH govern padoT 3 cooTBeTCTByioiííHM oópa3OM nepepa-daTHBaerca ΕΗφορΜθίζΐΗ b Buse bhxojíhhx οεγηθεοβ. Tanzi CZR-HajiH saBJíeHHH, odpa3ywreca b 3θβηοεμοοτη MexaHZ3Ma ot-yn-paBJíeHHH EaBJíeHHeM odteMOM zjie EHTepBajioM tvlh nojmepszBa-ΘΜΟΓΟ ZJIE KOHTpOJmpyeMOrO ZCKyCCTBeHHOrO EHXaHZH CHCTSMHynpaBJíeHHH annapaTa jyin zcKyccTBeHH oro ληχθηηη I and Q TanneB 3aBZCEM0CTE Z3dpaHH0r0 £ OnOJIHETeJII> HO i? o peJEHMa padOTHHHTepMHTTHpyícmero npzHyAZTejiBHoro zcKyccTBeHHoro εηχηηζη, npeodpa30BHBaioTCH MeMdpazaMZ b ycajnra, κοτορκθ no3BOJiHK) THeodxoíHMoe nepeKJimeHze jdíhez.
HeT HeodxojCKMOCTH β οπζοθηζε εογζηθοκζχ φ^κΐξκκ, βηποεηη©-μηχ dJiOKOM ’ΌΜ" 4 z dJioKaMii ’ΊΊ" 5, 6, τηκ nan οηζ noKa3aHHna HepTesce b cxewie ynpasjíeHEH. Tan nonasaH annapaT ajih hc-KyccTBSHHoro EHxaHEH npz penz^e padoT ”zcnyccTBeHHoe aaxaHzehojí nepejiywEMCH naBJíeHzeM (IPPE)”, πρΗ κοτοροΜ Ha roaeeBsoxa naixzeHry nonaeTcn εηχβτθεβηηζ ra3 c noHneHTpaiízefi kec-Jiopoza ot 21 jxo 100 od.$. Οτβηκθήζθ nanzeHTa ot ranoro az-TOMaTEHeCKOrO ZCKyCCTBSHHOrO ΖΗΧΗΗΕΗ Πρ0Η3Β0ΛΕΤ0Η Hepe3 ΗΟΛ-sepjKEBaeMoe IPPE cHanajia npz doJiLniož ^βοτβητθεβηοοτζ Tpzr-repa z c κοροτκΕΜΕ HepeptmaME, 3aTeM c hií3hotí ή^έοτβετθεβ-hoctbio Tpzrrepa z npojyieHHHMZ nepeptmaMz £0 nepenjmneHZH HaHHTepMHTTEpyioinee npzHyiizTeJiBHoe EHxaHze ( nav ),HanpzMep, C HOCTOHHHHM ΠΟΕΟΧΗΤβΕΒΗΗΜ JjaBJISHHOM B B03£ymHHX HyTHX (CPAP)Bo BpeMH nepepHBOB, κοτορηβ mosho 3βεητβ no TazMeTy, npozc-XOftHT CnOHTaHHHe BS0XH. B.WXaeKHe OdteMH ΗΜΘΙΟΤ.ηρΖ 3T0M paB-HOMepHyio 3asaHHyio KOHixeHTpauzio nzcjioposa, T.e., nanzeHT bsh-xaeT. EtixaTejiBHHz ra3 Tazoro ne nanecTBa, Kaz npz KOHTpoEzpy-θμομ hjiz nojcnepszBaeMOM IPPB. IIpeKMyinecTBO peinemiH coiuiacHo H30ópeTeHiw 3amnoHaeTCH bnoďoflHCTBe nepexosa oř IPPB nepe3 imv k οιιοητθηηομυ xu-XaHHiO H npOHBJLSeTCH B OCOÓeHHOCTH B TOM, ΉΤΟ Ča3a Bfloxa noxapaKTepHcraKe βρθμοηη, oó-beMa x xaBJíeHxx h xaaecTBa jn-rx-a-TejiLHoro ra3a ocTaercx óe3 H3MeHeHHH. ΠρχΜβρ ocymecTB^e-HKLH H30ÓpeTeHHH TaXSe C03HaTeJII>H0 HCKWiaeT B03M0SH0CTBTax HasHBaeMoro cnHxpoHH3xpoBaxHoro imv ( simv ), Taxxax npx orxjiKHeHHH annapara jyix xcKyccrBeHHoro μηχηηηχ na-ιχκθΗΤ, xax npaBmio, npoxBJLHer óeénoKoncTBO. PaHee yse óhjtocxa3aHO, hto nacTOTa .οποητβηηογο BfíHxaxEx pexxo BCTpenaeTCxb BHcmeií ronxe npHHyjpiTeJibHoro Bxoxa npn HcxyccTBeHHOM jmxahhh. Ecjix sto Bce se cJiyaaeTCH, to sto paBHocxjiLHo B3£oxy,HTO npn KOHTpOJIHpyeMOM HcxyccTBeHHOM XXXaHHH HBJíaeTCX OCHOBHHM TpeÓOBaHHeM.HeT HeodxojCKMOCTH β οπζοθηζε εογζηθοκζχ φ ^ κΐξκκ, βηποεηη © -μηχ dJiOKOM 'ΌΜ "4 of dJioKaMii" ΊΊ "5, 6, τηκ nan οηζ noKa3aHHna HepTesce b cxewie ynpasjíeHEH. Tan nonasaH annapaT ajih hc-KyccTBSHHoro EHxaHEH npz penz ^ e padoT ”zcnyccTBeHHoe aaxaHzehoi nepejiywEMCH naBJíeHzeM (IPPE)”, Η ro κ ro ro a a 3 3 3 H 3 3 3 3 3 3 3 3 3. Οτβηκθήζθ nanzeHTa ranoro and OT-TOMaTEHeCKOrO ZCKyCCTBSHHOrO ΖΗΧΗΗΕΗ Πρ0Η3Β0ΛΕΤ0Η Hepe3 ΗΟΛ-sepjKEBaeMoe IPPE cHanajia HPH doJiLniož ^ βοτβητθεβηοοτζ Tpzrrepa zc κοροτκΕΜΕ HepeptmaME, 3aTeM c hií3hotí ή ^ έοτβετθεβ-hoctbio Tpzrrepa of npojyieHHHMZ nepeptmaMz £ 0 nepenjmneHZH HaHHTepMHTTEpyioinee npzHyiizTeJiBHoe EHxaHze (NAV) HanpzMep , C HOCTOHHHHM ΠΟΕΟΧΗΤβΕΒΗΗΜ JjaBJISHHOM B B03 £ ymHHX HyTHX (CPAP) Bo BpeMH nepepHBOB, κοτορηβ mosho 3βεητβ no TazMeTy, npozc-XOftHT CnOHTaHHHe BS0XH. B.WXaeKHe OdteMH η.ηρΖ 3T0M paB-HOMepHyio 3asaHHyio KOHixeHTpauzio nzcjioposa, T.e., nanzeHT bsh-xaeT. EtixaTejiBHHz ra3 Tazoro no nanecTBa, Kaz npz KOHTpoEzpy-θμομ hjiz nojcnepszBaeMOM IPPB. IIpeKMyinecTBO peinemiH coiuiacHo H30ópeTeHiw 3amnoHaeTCH bnoďoflHCTBe nepexosa steed IPPB nepe3 IMV to οιιοητθηηομυ Xu H-XaHHiO npOHBJLSeTCH B B OCOÓeHHOCTH TOM ΉΤΟ CA3a Bfloxa noxapaKTepHcraKe βρθμοηη, OO-H Bema x xaBJíeHxx xaaecTBa nec-rx-and-TejiLHoro ra3a ocTaercx óe3 H3MeHeHHH. ΠρχΜβρ ocymecTB ^ e-HKLH H30ÓpeTeHHH TaXSe C03HaTeJII> H0 HCKWiaeT B03M0SH0CTBTax HasHBaeMoro cnHxpoHH3xpoBaxHoro IMV (SIMV) Taxxax npx orxjiKHeHHH annapara jyix xcKyccrBeHHoro μηχηηηχ on-ιχκθΗΤ, XAX npaBmio, npoxBJLHer óeénoKoncTBO. PaHee yse óhjtocxa3aHO, hto nacTOTa .οποητβηηογο BfíHxaxEx pexxo BCTpenaeTCxb BHcmeii ronxe npHHyjpiTeJibHoro Bxoxa npn HcxyccTBeHHOM jmxahhh. Ejix hundred BCE with cHyCHiHHHHHMHHMHHMHHMHHMHHMHHMHHMHHMHHMHHMH HHMM.
BpexHoe jw nanneHra BO3MOSHoe noxBJíeHxe πηχοβηχ χθβχθηηηnpesoTBpamaeTcx npenpxpaHXTejiLHHM KxanaHOM 18. 10BpexHoe jw nanneHra BO3MOSHoe noxBJíeHxe πηχοβηχ χθβχθηηηnpesoTBpamaeTcx npenpxpaHXTejiLHHM KxanaHOM 18. 10
H30EPETEM 1. ynpaBJíeHHe jyiH aBTOMaTimecKHX annapaTOB HCKyccTBeHHoro,ηηχηηηη c ynpaBJíemieM #aBJieHHH, HHTepBajiaMH hjih odseMOMΠρΗ HOKUep&HBaeMOM H KOHTpOJIHpyeMOM ECKyCCTBeHHOM ffLíXa-hhh, cocTOHmee H3 πηθβμο—JioriraecKnx HepeKjmqawix h yn-paBJíJBouíHX 9JieMeHT0B, co cxeMOíí ynpaBJíeHHH hjih HHTep— MHTTiipyfómero npHHywe^BHoro HCKyccTBeHHoro ,κηταηηη ( IM? )» κ KOTopofi othochtch θλθμθητη ynpaBJíeHHH no—3xpoBaHneM .Og, npenoxpaHHTejieM οτ H3dnTOHHoro naBJíeHHHπ BHpaBHHBaHHOM saajieHKH, oTJizHaioineecB τθμ, hto cxeMaynpaBJíeHHH ηβηηθτοη £oπoJIHHτeJIL·HOH cxeMOH ynpaBJíeHHH 2,ocHaiiieHHoS nepemnonaTejieM pona pador (3), tíJioKOM "IUIH" (4) h jíByMH dJionaMH ”11” (5, 6); hto nepemnonarejiL· po.uapadoT (3) co οτοροΗΗ Bxona coenHHeH c JniHHeft ynpaBJíeHHHBaBJíeHHeM (8) οζοτθμη ynpaBJíeHHH annapaTOM juih HCKyccTBenΗ0Γ0->JIJJXaHHH (I), a CO CTOPOHH BHX0.ua - c ΒΧΟΛΟΜ dJIOKa"HJIH” (4) h dJiOKOB "II” (5, 6) z hto dJiOKH ”11” (5, 6) hdjioK "W (4) nepea cboe BTopse bxohh coenHHeHu c jihhh-hmh cHrHajiH3aiíHH (9) MexaHH3Ma ynpaBJíeHHH naBjíeHzeM, hh-TepBajiaMK h odtewroM οηοτθμη ynpaBJíeHHH annapaTOM jijih hc-KyCCTBeHHOrO AHXaHHH (I), a CO CTOPOHH CBOHX BHXOAOB -C ΜΗΟΓΟΧΟ,ΊξΟΒΗΜ KJianaHOM (10), HaXOflHUÍHMCH B COe£EHeHHEc jniHneS ynpaBJíeHHH nasjíenzeM (8) c nepemnonaTejieM nopo-Γ0ΒΗΧ 3HaneHHH (II) H KOMdHHaipíř H3 OdpaTHOrO Η ΜΗ0Γ0Χ0—βΟΒΟΓΟ KJianaHOB (12), κοτορκθ, b cboe onepenB, nepe3H3BecTHne nepeKJiEHajoiííHe z ynpaBJLHEnpie aneMeHTH coeflKHe-HH C y-0dpa3HHM &7ΙΘΜβΗΤΟΜ y ΠΟβΚΙΙΕΗθΗΗΗ ΠΒΙξΗθΗΤΗ (15). 2. ynpaBJíeHHe corjiacHO nyHKTy I, oTjranaioDieecH TeM, hto nepe-KJnoHaTejiB pona padoT (3) BHnojiHHeT 3/2 cpyHKixzz h co cto-poHH BXOfía coejmHeH c jiHHHeH ynpaBJíeHHH saBJíeHHeM (8),sejiyineH κ nosKjnoHeHHE Og (7) οηοτθμη ynpaBJíeHHH annapa-TOM jyiH HCKyCCTBeHHOrO HHXaHHH (I), a CO CTOpOHH BHXO— 11H30EPETEM first ynpaBJíeHHe jyiH aBTOMaTimecKHX annapaTOB HCKyccTBeHHoro, ηηχηηηη c ynpaBJíemieM #aBJieHHH, HHTepBajiaMH hjih odseMOMΠρΗ HOKUep & H HBaeMOM KOHTpOJIHpyeMOM ECKyCCTBeHHOM ffLíXa-hhh, cocTOHmee H3 πηθβμο JioriraecKnx HepeKjmqawix h-yn-paBJíJBouíHX 9JieMeHT0B what cxeMOíí ynpaBJíeHHH hjih HHTep- MHTTiipyfómero npHHywe ^ Bhor HCKyccTBeHHoro, κηταηηη (M?) »κ KOTopofi othochtch θλθμθητη ynpaBJíeHHH no-3xpoBaHneM .Og, npenoxpaHHTejieM οτ H3dnTOHHoro naBJíeHHHπ BHpaBHHBaHHOM saajieHKH, oTJizHaioineecB τθμ, HTO cxeMaynpaBJíeHHH ηβηηθτοη £ oπoJIHHτeJIL · HOH cxeMOH ynpaBJíeHHH 2 ocHaiiieHHoS nepemnonaTejieM PADOR extension part (3) tíJioKOM" IUIH "(4) h eatByMH dJionaMH" 11 "(5, 6); hto nepemnonarejiL · po.uapadoT (3) what οτοροΗΗ Bxona coenHHeH c JniHHeft ynpaBJíeHHHBaBJíeHHeM (8) οζοτθμη ynpaBJíeHHH annapaTOM juih HCKyccTBenΗ0Γ0-> JIJJXaHHH (I) and CO CTOPOHH BHX0.ua - c ΒΧΟΛΟΜ dJIOKa "HJIH" (4) h dJiOKOB " II ”(5, 6) from hto dJiOKH” 11 ”(5, 6) hdjioK" W (4) nepea cboe BTopse bxohh coenHHeHu c jihhh-hmh cHrHajiH3aiíHH (9) MexaHH3Ma ynpaBJiHHH naBjíeHzeM, hh-TepBajiaMK h odtewroM οηοτθμη ynpaBJíeHHH annapaTOM jijih HC-KyCCTBeHHOrO AHXaHHH (I) and CO CTOPOHH CBOHX BHXOAOB -C ΜΗΟΓΟΧΟ, ΊξΟΒΗΜ KJianaHOM (10), Coe HaXOflHUÍHMCH B £ EHeHHEc jniHneS ynpaBJíeHHH nasjíenzeM (8) c-nepemnonaTejieM NOPO Γ0ΒΗΧ 3HaneHHH (II) H H3 KOMdHHaipíř OdpaTHOrO Η ΜΗ0Γ0Χ0- ΟΒΟΓΟ J iana J J ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ ΟΒΟΓΟ y y y y y y y y y 15 15 15 15 15 15 15 15 I I I I I I I I I I I I TjranaioDieecH those NEP-HTO KJnoHaTejiB padoT extension part (3) BHnojiHHeT cpyHKixzz 2.3 h as CTO-poHH BXOfía coejmHeH c jiHHHeH ynpaBJíeHHH saBJíeHHeM (8) sejiyineH κ nosKjnoHeHHE Og (7) οηοτθμη ynpaBJíeHHH annapa-TOM jyiH HCKyCCTBeHHOrO HHXaHHH (I) , and CO CTOpOHH BHXO - 11
Ba - aepe3 npHMofí CTaTirqecKEfi bxob - c Óbokom 'W (4),a TaK&e Karoiíí pa3 aepe3 oópaTmríí οτβτηηθοκχγη bxob c nep-BUM ÓJIOKOM ”H" (5) E CO BTOpHM ÓBOKOM ”K” (6). ynpaBJíeHEe coímacHO nyHKTy I h 2, oTBunaiomeecH τθμ, htonepeMKnaiejiL· noporoBHX 3HaHeHHE (II) εμθθτ CBH3B c ποβ-ΚΕΚΗΘΗΗΘΜ ΙΙΗΓζΗθΗΤΗ (15), KOTOpoe, C OBHOX CTOPOHH, Ήθρθ3KJianaH PEEP/CPAP (16) h cBH3aHHíJH c hhm βηβηχητθββηηη jma-nan (17) ποβκώοηθη K cHCTeMe ynpaBJíeHHH annapaTOM rjir hc-KyccTBeHHoro BHxaHHH (I), a, c jipyrot ctopohh, pa3 κ npe-BOxpaHETeBtHOMy KJianany (18) h KanuieBOMy KjianaHy (19) hBpyroír pa3 κ msceKTopy (21), coejmHeHHOMy c hotohhhm KJia-naHOM (20) Η MHOFOXOBOBHM KJianaHOM (10), HTO HHaeKTOp (21)HMeeT Bocryn κ ynpaBjraeMOMy MeMópaHaME 3aiBopy κομ6ηηηερϊεE3 odparaoro η μηογοχοβοβογο KJianaH ob (12), KOTopas Eepe3obkh nyTB coeBHHeHa c κηιπηθβημ KJianaHOM (19) h βο3τοτιιηημφΗΒΒτροΜ (22), a aepe3 BPyrog xob, BO-nepBHX, η πρη npo-Me&yTOHHOM ποβκτποηθηεη npoTonHoro KJianaHa (23) h pacxoBo-Mepa (24) c noBaneS Og (7), a Βο-Βτορκχ, c ypaBHETeJiBHHMcocyEOM (25) e npeBoxpaHHTeBBHHii KJianaHOM (26). 4. ynpaBJíeHHe coímacHO nyHKTy 2, OTjEEHaioiiieec^ τθμ, hto nepe-KJimaTeBB po;o;a padoT (3), ójiok "HJF (4) κ ójiokh ”H” (5, 6)cocTaBJLfWT o£KH y3eji h κομπ3κτηο οοθβηηθηη Bpyr c BPyroM. 5. ynpaBJíeHEe corjiacHo nyHKTy 3, oTJiEqaEsueecH τθμ, hto yripas-Jiawie KJianaHH (20, 23) ,a Tanse neperjnoHaTeJiB noporoBHXnapaMeTpoB (II), KJianaH PEEP/CPAP (16) e npeBoxpaHETejiBHHEKJianaH (18) bo3mosho peryjmpoBaTB. 12Ba - aepe3 npHMofí CTaTirqecKEfi bxob - c Óbokom 'W (4), and TaK & e Karoiíí pa3 aepe3 oópaTmríí οτβτηηθοκχγη bxob c nep-BUM ÓJIOKOM ”H” (5) E WHAT BTOpHM ÓBOK ” I h 2, oTBunaiomeecH τèμ, htonepeMKnaiejiL · noporoBHX 3HaHeHHE (II) CBH3B c ο π ββ-ΚΗΘΗΗΘΜΕΚΗΘΗΗΘΜ ΙΙΗΓζΗθΗΤΗ (15), cOpOxeCopoH, ρθρθ3KJianaH PEEP / CPAP (16) h cBH3aHHiJH c hhm βηβηχητββηηη jma-nan (17) ποβκώοηθη CHCTeMe ynpaBJiHHH annapaTOM rjir hc-KyccTBeHHoro BHxaHHH (I), a, c jipyrot ctopohh, pa3 κ npe-BOxpaHETeBtHOMy KJianany (18) h KanuieBOMy KjianaHy (19) hBpyroir pa3 κ msceKTopy (21), coejmHeHHOMy c hotohhhm ) η MHOFOXOBOBHM KJianaHOM (10) HTO HHaeKTOp (21) HMeeT Bocryn κ ynpaBjraeMOMy MeMópaHaME 3aiBopy κομ6ηηηερϊεE3 odparaoro η μηογοχοβοβογο KJianaH ob (12) KOTopas Eepe3obkh nyTB coeBHHeHa c κηιπηθβημ KJianaHOM (19) h βο3τοτι (22), aepe3 BPyrog xob, BO-nepBHX, η πρη npo-Me & yTOHHOM ποβκτποηθηεη npoTonHoro KJianaHa (23) h pacxoBo-Mepa (24) c noBaneS Og (7), and Βο-Βτορκχ, c ypaBHETeJiBHHMcocyEOM (25 ) e npeBoxpaHHTeBBHHii KJianaHOM (26). 4. ynpaBJíeHHe coímacHO nyHKTy 2, OTjEEHaioiiieec ^ τθμ, hto nepe-KJimaTeBB po; o; c BPyroM 5. ynpaBJíeHEe corjiacHo nyHKTy 3, oTJiEqaEsueecH τèμ, hto yripas-Jiawie KJianaHH (20, 23), and Tanse neperjnoHaTeJiB noporoBHXnapaMeTpoB (II), KJianaH PEEP / CPAP (16) e npeBoxpaHETejiBHHEKJianaH (18) bo3mosho peryjmpoBaTB.
AHHOTAW H3odpeTeHHe othochtch κ γπρεικπβΗϊπο aBTOMaTiraecKHMH annapa-τθμη ftJiH HCKyccTBSHHoro nnxaHHH c ynparwieHHeM flasJíeHneM,HHTspBajtaMK ηλη ofoeMOM npn nojmepjmaeMOM ηλη KOHrpojmpy~ΘΜΟΜ HCKyCCTBeHHOM ΛΗΧΗΗΗΗ CO CXeMOS ynpaBJíeHHH &M HHTep-MHTTnpyiomero npi-iHyjxHTejitHoro HCKyccrBeHHoro ληχθηηη ( imv )AHHOTAW H3odpeTeHHe othochtch κ γπρεικπβΗϊπο aBTOMaTiraecKHMH annapa-τθμη ftJiH HCKyccTBSHHoro nnxaHHH c ynparwieHHeM flasJíeHneM, HHTspBajtaMK ηλη ofoeMOM npn nojmepjmaeMOM ηλη KOHrpojmpy ~ ΘΜΟΜ HCKyCCTBeHHOM ΛΗΧΗΗΗΗ CO CXeMOS ynpaBJíeHHH & M-HHTep MHTTnpyiomero NPI-iHyjxHTejitHoro HCKyccrBeHHoro ληχθηηη (IMV)
UejiB n3oópeTeHHH 3amnoHaeTCH b yHynineHHH pesiMa paóoTH imvΗ B B03M0KH0CTH ΟΠΟΗΤΘΗΗΟΓΟ ΛΗΧΘΉΗΗ ΠρΗ ΠΟΛΟΚΗΤΘΛΒΗΟΜ pOB~HOM ΛΘΒΛΘΗΗΕ B ΚΟΗΙίβ BHXOfla (PEEP) C COXpaHeHEeM ΠΟΟΤΟΗΗΗΟΓΟΠΟΛΟΚΗΤβΛΒΗΟΓΟ ΛΒΒΛΘΗΞΗ B flHXaTβΛΒΗΗΧ nyTHX (CPAP). Οογληοηο H3oópeTeHiw cxeMa γπρβΒΛθΗΗΗ ηβληθτοη ήοποληητθλβ-hhm ynpaBHeHHeM, coctohiiihm H3 nepeKJiKPiaTejLa po#a paóoT, 0λο-Ka ”MJET" h nsyx óhokob ”H”, κοτοροθ co ctopohu Bxosa CBH3a—HO Ήθρβ3 ΛΗΗΗΙΟ ΟΗΓΗ3ΛΗ3ΒΙΧΗΗ ΜΘΧΗΗΗ3ΜΗ ^ΓΠρΗΒΛΘΞΗΗ βθΒΛΘΗΗΘΜ,ΗΗΤθρΒΘΛΗΜΗ Η OÓieMOM C γπρΗΒΛΘΗΗΘΜ aiinapaTOM ΠΛΗ HCKyCCTBOHΗΟΓΟ ΛΗΧΘΉΗΗ, a CO CTOpOHH ΒΗΧ0Λ3. Ηβρβ3 MHOIOXOflOBOH lUianaH,ΠΟρθΚΛΙΟΉΒΤ&ΖΪΒ ΠΟρΟΓΟΒΗΧ Π0ΚΒ3ΒΤ6ΛΘΗ Η KOMÓHHaiHW Η3 OÓpaT-ηογο η μηογοχο#οβογο raianaHOB, a Tarase nepe3 noflJunoneHHHe3a hhmh neperaxKHaOTte h ynpaBHjnoinHe θλθμθητη c πολκλιοηθηηθμnanneHTa.Ej ΟΗΤΘΗΗΟΓΟ 3 ó am am am am H T OB OB OB OB OB M ó OB OB OB OB OB OB OB OB OB ΟΗΤΘΗΗΟΓΟ Π Π fl TH TH TH TH TH TH TH TH TH TH TH TH TH TH TH TH Οογληοηο H3oópeTeHiw cxeMa γπρβΒΛθΗΗΗ ηβληθτοη ήοποληητθλβ-HHM ynpaBHeHHeM, coctohiiihm H3 nepeKJiKPiaTejLa after # and paóoT, 0λο-Ka "Mjet" h nsyx óhokob "H" κοτοροθ what ctopohu Bxosa CBH3a HO Ήθρβ3 ΛΗΗΗΙΟ ΟΗΓΗ3ΛΗ3ΒΙΧΗΗ ΜΘΧΗΗΗ3ΜΗ ^ ΓΠρΗΒΛΘΞΗΗ βθΒΛΘΗΗΘΜ, ΗΗΤθρΒΘΛΗΜΗ Η OÓieMOM C γπρΗΒΛΘΗΗΘΜ aiinapaTOM ΠΛΗ HCKyCCTBOHΗΟΓΟ ΛΗΧΘΉΗΗ and CO CTOpOHH ΒΗΧ0Λ3. Ηβρβ3 MHOIOXOflOBOH lUianaH, ΠΟρθΚΛΙΟΉΒΤ & ΖΪΒ ΠΟρΟΓΟΒΗΧ Π0ΚΒ3ΒΤ6ΛΘΗ η KOMÓHHaiHW Η3 OÓpaT-ηογο η μηογοχο # οβογο raianaHOB and Taras nepe3 noflJunoneHHHe3a hhmh neperaxKHaOTte h ynpaBHjnoinHe θλθμθητη πολκλιοηθηηθμnanneHTa C.
Claims (4)
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DD78209085A DD140651A1 (en) | 1978-11-15 | 1978-11-15 | CONTROL FOR AUTOMATIC PRESSURE, TIME OR VOLUME CONTROLLED VENTILATORS |
Publications (1)
Publication Number | Publication Date |
---|---|
CS233303B1 true CS233303B1 (en) | 1985-02-14 |
Family
ID=5515324
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CS797058A CS233303B1 (en) | 1978-11-15 | 1979-10-17 | Control system of automatic apparatus for artificial respiration with pressure, interval or volume control |
Country Status (5)
Country | Link |
---|---|
CS (1) | CS233303B1 (en) |
DD (1) | DD140651A1 (en) |
DE (1) | DE2932161A1 (en) |
HU (1) | HU187257B (en) |
SE (1) | SE432356B (en) |
Families Citing this family (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3209413A1 (en) * | 1982-03-16 | 1983-09-22 | Carl A. Hoyer, Medizin-Technik, 2800 Bremen | DEVICE FOR HIGH-FREQUENCY MACHINE VENTILATION |
DE3629126A1 (en) * | 1986-08-27 | 1988-03-10 | Draegerwerk Ag | PRESSURE MONITORING DEVICE FOR A BREATHING DEVICE |
DE3820043C2 (en) * | 1987-11-20 | 1999-10-28 | Anton Obermayer | Breathing apparatus |
DE3906202A1 (en) * | 1989-02-28 | 1990-09-06 | Medicommerz Gmbh | METHOD AND DEVICE FOR SUPPLYING BREATH GAS |
DE4038871A1 (en) * | 1990-12-03 | 1992-06-04 | Peter Dr Sc Techn Schaller | Respirator control using sensor to measure breath vol. or flow - and supplying signal processor also receiving resistance, inverse compliance and any leakage vol. values as well as threshold values to control breathing pressure |
CN114209940B (en) * | 2021-12-30 | 2024-01-02 | 江苏鱼跃医疗设备股份有限公司 | Breathing phase control method of breathing machine based on dynamic threshold |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4164219A (en) * | 1976-10-08 | 1979-08-14 | Minnesota Mining And Manufacturing Company | Ventilator |
DE2801546C2 (en) * | 1978-01-14 | 1982-09-09 | Drägerwerk AG, 2400 Lübeck | Ventilator especially for small children |
-
1978
- 1978-11-15 DD DD78209085A patent/DD140651A1/en not_active IP Right Cessation
-
1979
- 1979-08-08 DE DE19792932161 patent/DE2932161A1/en not_active Withdrawn
- 1979-09-11 SE SE7907506A patent/SE432356B/en unknown
- 1979-10-17 CS CS797058A patent/CS233303B1/en unknown
- 1979-10-17 HU HU79ME2310A patent/HU187257B/en unknown
Also Published As
Publication number | Publication date |
---|---|
DE2932161A1 (en) | 1980-09-04 |
SE432356B (en) | 1984-04-02 |
HU187257B (en) | 1985-12-28 |
SE7907506L (en) | 1980-05-16 |
DD140651A1 (en) | 1980-03-19 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CS233303B1 (en) | Control system of automatic apparatus for artificial respiration with pressure, interval or volume control | |
DE4432219C1 (en) | Automatic breathing system for patients | |
US10272222B2 (en) | Treatment device and method of use | |
MX2017000056A (en) | Flow regulating inhaler device. | |
CN105813674B (en) | The fume extractor of maintenance pressure in insufflator | |
EP4282457A3 (en) | Exhalation port | |
WO2017035406A3 (en) | Eye-related intrabody pressure identification and modification | |
DE102013011983B4 (en) | Medical measuring device, ventilation device and method for operating a medical measuring device or for operating a ventilation device | |
Friis et al. | European Code against Cancer 4th Edition: Medical exposures, including hormone therapy, and cancer | |
US3834382A (en) | Fluidic respirator control system with patient triggering response means | |
EP2762179A3 (en) | Apparatus for extracorporeal treatment of blood | |
CN110237393B (en) | Artificial respiration appliance with switching valve | |
EP4235145A3 (en) | Systems for delivering gas to a patient | |
US11752285B2 (en) | System and method for accurate estimation of intentional and unintentional leaks in flow generation systems | |
EP4316556A3 (en) | Breathing control using high flow respiration assistance | |
CA2923173C (en) | Apparatus to provide breathing support | |
DE2801546A1 (en) | VENTILATION DEVICE ESPECIALLY FOR SMALL CHILDREN | |
US20180036480A1 (en) | Device for Administration of Fluid Medicaments | |
EP4445935A3 (en) | Systems for controlling oxygen delivery in a flow therapy apparatus | |
EP4309718A3 (en) | Gas therapy system for delivery of medicament | |
EP3349822B1 (en) | Control system | |
DE102014006780A1 (en) | Respiratory device and method for determining a fresh gas flow | |
EP3181159A1 (en) | Pressure control method and system thereof | |
WO2020051096A8 (en) | Methods and systems for high pressure controlled ventilation | |
Weiser et al. | Paying it forward: A pilot program for near-peer support for medical students during the surgery clerkship |