“Tidal volume”的意思、由来-开放百科全书

词条

Tidal volume

释义

Mechanical ventilation
For patient without preexisting lung disease For patients with chronic obstructive lung disease Acute respiratory distress syndrome
References
External links

{{Refimprove|date=October 2009}}{{Pulmonary function}}Tidal volume (symbol VT or TV) is the lung volume representing the normal volume of air displaced between normal inhalation and exhalation when extra effort is not applied. In a healthy, young human adult, tidal volume is approximately 500 mL per inspiration or 7 mL/kg of body mass.^[1]

Mechanical ventilation

Tidal volume plays a significant role during mechanical ventilation to ensure adequate ventilation without causing trauma to the lungs. Tidal volume is measured in milliliters and ventilation volumes are estimated based on a patient's ideal body mass. Measurement of tidal volume can be affected (usually overestimated) by leaks in the breathing circuit or the introduction of additional gas, for example during the introduction of nebulized drugs.

Ventilator-induced lung injury such as ALI/ARDS can be caused by ventilation with very large tidal volumes in normal lungs, as well as ventilation with moderate or small volumes in previously injured lungs, and research shows that the incidence of ALI increases with higher tidal volume settings in nonneurologically-impaired patients.

^[2]

Initial settings of mechanical ventilation:

For patient without preexisting lung disease

Protective lung Ventilation strategies should be applied with Vt 6ml/kg to 8ml/kg with RR = 12 to 20 and an average starting target minute ventilation of 7 l/min

For patients with chronic obstructive lung disease

Protective lung volumes apply 6ml/kg to 8ml/kg with a rate high enough for proper alveolar ventilation but does not create or aggravate intrinsic peep

Acute respiratory distress syndrome

Protective Lung Ventilation Strategies apply. Vt 6 to 8 ml/kg or as low as 5ml/kg in severe cases. Permissive hypercapnia can be employed in an attempt to minimize aggressive ventilation leading to lung injury. Higher peeps are often required however not all ARDS patients require same peep levels. Patient should be started on 6 ml/kg and peep increased till plateau pressure is 30 cmH20 in most severe cases.

References

1. ^Beardsell, I et al: MCEM Part A:MCQs, page 33, Royal Society of Medicine Press, 2009
2. ^{{cite journal|last=Gajic|first=Ognjen|author2=Saqib Dara |author3=Jose Mendez |author4=Abedola Adensanya |author5=Emir Festic |author6=Sean Caples |author7=Rimki Rana |author8=Jennifer StSauver |author9=James Lymp |author10=Bekele Afessa |title=Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation|journal=Critical Care Medicine- Baltimore|year=2004|volume=32|issue=9|pages=1817–1824|accessdate=}}

External links

{{Cite journal |author=Ricard JD |title=Are we really reducing tidal volume--and should we? |journal=American Journal of Respiratory and Critical Care Medicine |volume=167 |issue=10 |pages=1297–8 |date=May 2003 |pmid=12738592 |doi=10.1164/rccm.2303003 |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=12738592 |accessdate=2012-05-19}}

{{Respiratory physiology}}{{DEFAULTSORT:Tidal Volume}}Atmung#Atemzugvolumen

2 : Respiratory physiology|Respiration

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