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在机械通气治疗过程中,处理人机对抗有哪些措施?

问答题
2022-04-02 13:43
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正确答案
①用于手法过度通气,将二氧化碳分压降低,自主呼吸变弱,然后接上呼吸机,并保持合适的潮气量;
②将呼吸机频率调到与病人自主呼吸合拍,适应后再将呼吸机频率逐渐调到正常范围.若病人呼吸太快,可间隔辅助呼吸;
③微弱的自主呼吸,不干扰呼吸机的工作,也不影响病人的呼吸或循环功能,若无大汗、烦躁等表现,可不干处理.严重的不合拍,经上述处理仍不改善者,应注意是否有张力性气胸、大片肺不张、肺部感染等并发症,应及时处理;
④谨慎应用辅助药物,成人用吗啡5~10mg,以少量分次静注较好,同时注意血压,其他镇静药如地西泮(安定)、咪哒唑仑、丙泊酚等.也有助于消除自主呼吸.有些病人经上述处理仍不合拍,只能用肌松药来消除自主呼吸,如用阿曲库铵,单次静注0.5mg/Kg,潘库溴铵,单次静注0.8mg/kg,必要时可反复给药.
应注意的是上述人机对抗处理措施,必须征得主管医师同意或在其指导下进行。

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