高流量氧疗的生理效应,俞康龙
25页1、高流量氧疗的生理效应,Physiological Effect of High Flow Nasal Cannula (HFNC) Therapy,上海交通大学第一人民医院急诊与危重病科 俞康龙,COI statement,The author has no conflict of interest to declare.,High Flow,an interesting oxygenation method,- novel - magic - gentle and moderate,So cool,HFNC shines during RSI,Put the big cannulae into your patients nose and letr rip. Add a face mask or NIV or whatever your preoxygenation pleasure, then push your meds and laugh to yourself as the saturation rises during apnea. Whistle sweetly as t
2、he intern illuminates every inch of the soft palate with great determination. Hell, go see another patient and tell him to call you when hes given up.,You remember, though, the days of the giants. When being regarded as a skilled laryngoscopist meant something. When the word airway made internists scatter like mice. When it wasnt so easy to save a life. http:/ has promoted oxygen therapy,Oxygen therapy & oxygen delivery devices,HFNC,The role of HFNC in respiratory therapy,What is HFNC?,a “new” m
3、ethods of oxygen therapy air/oxygen applied to patient at high flow rates air/oxygen run through a nasal cannula air/oxygen is well conditioned by sufficient warmth and humidification -so called heated, humidified high-flow nasal cannula (HHHFNC) therapy,2-70 L/min,Mechanisms of action for HFNC,Washout of nasopharyngeal dead space Reduction of inspiratory resistance (work of breathing) by providing adequate flow Improved mechanics by supplying adequately warmed and humidified gas Reduction in th
4、e metabolic cost of gas conditioning Provision of distending pressure,Washout of nasopharyngeal dead space,The high volumetric flows pouring from a small bore cannula cause high velocity flows which create turbulent energy to flush the upper airway of expiratory gas.,Dead space washout improves ventilation,anatomical dead space in adults 30% of tidal volume in neonates 50% of tidal volume change the gas composition in nasopharyngeal space reduce rebreathing expired CO2 increase the fraction of i
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