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1. ........................................... 3
....................................................................................................... 4
2. ............. 5
......................................................................................................... 5
,
....................................... 5
,
.............................................................................................. 7
3. ..................................................... 8
................................................................................................ 8
.................................................................. 9
- Volume control ventilation
............................................................................................................. 10
- Pressure control ventilation -
........................................................................................................ 15
......................................................................... 20
.............................................................. 21
Pressure support ventilation
.......................................................................................................... 22
/ (Positive End-Expiratory Pressure /Continius Positive Airway
Pressure - /
) ........................................................................................................... 24
4. ...................................................... 26
............................................................................................................... 27
....................................................... 29
CMV(Continius Mandatory Ventilation) -
......................................................................................................... 29
(S)CMV (Synchronized Continius Mandatory Ventilation) ........................ 29
Spont ............................................................ 30
SIMV (Synchronized Intermittent Mandatory Ventilation)
............ 31
(s)cmv simv ..................................................................... 32
5. .............................. 33
Sigh - ............................................................................................. 33
IRVintensive ratio ventilation
/ ......................................................................................................... 33
BiPAP-BIFASICpositive airway ressure -
........................ 34
Pressure limited ventilation (PLV) - ()
............................................................................................................ 36
Apnoe Ventilation - ................................................................. 37
VAPSvolume assured pressure support
, ..................................................... 38
6.
............................................................................ 39
........................................................................................................... 42


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Pressure support, SIMV,
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SIMV , (Pressure support),
.
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42

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pressure support) , - CMV, (s)CMV, SIMV - .
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mode )
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:
SIMV, , -1 20,
Volume control + Pressure Support (VC - 10 I (
- 65 /, -0.9 ., -deceleration), PSV
+ 20 2,, /+ 7 H2O,FiO2,- 0.4, -


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.
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41

- 11.5-12 /, 1 8 1 , Pressure support-400-460 .


- Pressure limited ventilation, BiPAP, VAPS.

2.


Volume control deceleration-
, ,
.
.
, .
Pressure control:

-
% .
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(d:7 ,
. , (d:8 .
Volume control :
(Volume control,
deceleration flow)
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.

40

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).
Tidal volume ).
. (500-300 )
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() ("frequency" - F) - / - = . (2 - 35-44
Hg) ,
, -
(26-28 1 ) , ( 10 I ) -

("airway pressure" - ) - (1 2 1 mBar).


. - ( -1--2
2) (+1- +2 2) . -
, ( +5 +30 30),
, ,
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, ,
. - Volume assured presssre support
VAPS
-
,
, . , VAPS , . , . , - , , .
, VAPS ,
Pressure support, .

6.


.
,
.
. , . , , .
. 15 , 50 , ,
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ml,f- 16 p/min, Bird 8400Sti. 12.8 . ,
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!,
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39


. .
, , , .

VAPSvolume assured pressure support


,
VAPS - Bird Bird 8400sti-oco6 , , ,
. , Pressure support. ,
PSV
,
PSV , , . , . ; .
. -
.

VAPS , , , , . VAPS
( ) -

38

. ,
( . ,
) , ,
, (airway flow) - . (/).
, . ,
,
(inspiratory flow) , , (expiratory flow)

.
, ,
. ()
50-70 /, (,
) 20-30 /, - 90-1 10 /.

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.

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: /, /, /.

(Volume orientated ventilation Drager Evita 4


Auto Flow). PVL
,
(airway resistance) Pressure
control ventilation (deceleration flow). , PLV , . ! Pressure limited ventilation
Drger
Evita .
, . , " " " ", .
,
, ..
. .
.

Apnoe Ventilation -
,
.
(20-60 ),
. ,
.
,
. , , .
Minimum minute volume (MMV)
MMV -
.
, .
,
. .
, .
-

37

Pressure limited ventilation (PLV) - ()


Pressure limited ventilation - Drager, Evita. , , ,
Volume control Pressure control ventilation. Volume control ventilation Pressure
control ventilation .
, - , .
( IPPV (CMV) SIMV) , VCV . , .
.

,
.


,
, ( - CMV - volume
control . -6 ). (passive patient, ,
(mandatory),
-
(support).
, ,

,
, .
( mandatory ) (modes) (lume comrol
Pressure control ventilation modes , . , - Pressure
control .

,
,
, - Pressure limited ventilation PLV.

).
-
-volume control ventilation (pressure
control ventilation) ( 6 , - - PLV, VAPS, BiPAP (PCV).)
,
.

, Pressure limited ventilation Volume control ventilation,


- Pressure control ventilation,

36

.
, , . , Pressure support (ASB), . BiPAP (PCV+)
, 10-15 1 Pressure control ventilation
SIMV. BiPAP -
, ,
. BiPAP APRV (airway pressure release ventilation). , BiPAP Pressure support ventilation
( Evita-4
Nellcor Puritan Bennett 840).
BiPAP ,
BiPAP , SIMV. .
.

- Volume control ventilation


Volume control ventilation
Volume control
(Inspiration Time)
(lnspiratory Flow),
(Tidal Volume), .. (:
= , X
,
: + (Bird), + (Newport). + (Veolar - /). ,
- ,
.

.
1 ('onlzol -

10


( 10 ).
BiPAP (PCV+)
, .

35


, /
,
- . , , 10 20 2.
, . , 2 ,
- . APRV (airway pressure
release ventilation) - ,

.

,
. () - . .
, , () -
( ). .. (compliance
) .
, , , (, ).

, .

BiPAP-BIFASICpositive airway ressure -



(BiPAP ,
SIMV. . .)
BiPAP ( PCV+) - Drager Evita Nellcor
Puritan Bennett 840. Pressure control ventilation ( BIPAP PCV+)
(1) . , PCV BiPAP (PCV+) -

34

, Volume
control ventilation (VCV) - :
. .
, , - () . -

11

(, )
( 30 2)
() .
Volume control ventilation ( ) . VCV .
. , - ( , - , , ). Volume
control ventilation ,
- ( ), , . , , ,
(60-70 /), ( ) 90-100 /. , VCV - .
Volume control ventilation ( .).
, Volume control ventilation . , , . , - , , ,
, , . ,

.
- , - , ,
. , , . ,
..
( ). NB
.
Volume control ventilation

, . , , ,
.

12

.
SIMV (S)CMV. - ,
SIMV (S)CMV,
. , SIMV
- Spont, , SIMV
,
, .
SIMV

.

5.


,
.
, , .
, ,
.

Sigh -
Sigh - , (CMV, SIMV). ( 2-5 )
1.5-2 . ,
. Sigh , , .

IRVintensive ratio ventilation /


/, - 1:2-1:1. , ,
,
, , . / - 3:1-4:1. , Volume
control(CMV (SIMV) Pressure control/CMV (SIMV). intensive ratio
ventilation , , .
Airway pressure relese ventilation (APRV) - -

33


SIMV: SIMV
. -
, . SIMV CMV. -

.-
SIMV Spont.

Volume control ventilation , .


, . ,

. ,
.
,
. (Veolar), 6-7 .

(s)cmv simv
-
CMV,(S) CMV (/. IPPV) SIMV - Volume
control -
.
- (S)CMV
, , , ;
SIMV
, . -

32

13


Spont:

. , , ,

. Spont / Pressure support (ASB).

SIMV (Synchronized Intermittent Mandatory Ventilation)



Volume control, Pressure
control,

Pressure snpport. (I) . , ' . , (S)CMV, ,
,
/ Pressure Support. , SIMV .

14

31

( PEEP)
, , - , ,
, ..
(S)CMV CMV. :
(S)CMV / (Assist/Control),
Drager- IPPV (Intermittent Positive Pressure
Ventilation). / IPPV
CMV.

,
1 112, ,
( )
17 2.
1.5 2 ,
-
.

- Pressure control ventilation -



Pressure control ventilation (
Pressure control ventilation -
(Inspiration pressure) .

(inspiration Time) . . .
( ), , . Volume control, Pressure control ventilation
, .. , .

Spont
( Spont . SIMV - 0.)

, ( / Pressnre Support (ASB). , .
,
, .
CMV
.

30

15

, ,
, , , - , . , , Pressure control ventilation HE
. Pressure control ventilation
, , .
, . , ,
!


,
; ,
. Puritan Bennett, Servo Ventilator
(Simens)., Veolar (Hamilton medical).

CMV(Continius Mandatory Ventilation) -


, . Volume control Pressure control. , (V). Volume control X
. ,
( ) Volume control . ( , , , ).

(S)CMV (Synchronized Continius Mandatory Ventilation)


Pressure control ventilation (PCV),
, , ( (minute volume). ,
PCV (alarm).
,
,
Volume control ventilation
).
Pressure control ventilation . Volume

16

(S)CMV CMV , - (S)CMV ,


- .. (S)CMV .
,
1 / . , ,
, .. I /. , , , (S)CMV .
-
, ,
,
.
CMV
(S)CMV: .

- CMV Volume control,


CMV Pressure control.

(S)CMV

, , , , -

29

-2 20 +3 20. ,
, ..
.
(flow trigger Flow by) -
. Flow by -
-
Purittan Bennett-7200
. , , . ,
. -
.
.
, ,
- , .. . .
, - ,
, , ..
, ,
, .

28

control ventilation PCV,



- . , ..

( Volume control, , ~ . , PCV . -PCV (mandatory) , .. , .. , (
CMV SIMV).
, Pressure control ventilation , Volume control. () . (
- ) - .
Volume control , . . , , , . Pressure control ventilation
.
,
Pressure control ventilation - .

PCV
'
) , , .

PCV , .. .

PCV VCV ,
, .. .

. PCV ,
. (Pressure
control ventilation) .
(pressure control ventilation)
.
?
, -

17

,
.
, . ,
.
(17 2) (1.3 ).
, .
(900 )

Time Cycled . , VCV, . Pressure control Pressure cycled)


.
.
Pressure cycled - , - .
.
Pressure support ventilation
-
.
Pressure support ventilation
Time cycled - - . (CMv, SIMV). ,

. , ,
,
.

.


. .
, :
(pressure trigger) - .
( - 1 6
2), ,
. , -1-2 2.
,
.
,
(
), ..
(/) +5 2,

18

27

, ( ),
. , /
, .

.

( ),
:

Volume control, Pressure control. , .

Pressure support (ASB), . .


.

. .

4.
- .
- .

.
.
(passive patient). (mandatory) .
, (Trigger - - ,
), .. .
. , .
,
, -
( ,
.). :
Volume cycled , -
.(NB! Volume control ventilation ( ) Volume cycled ventilation (-
). ,
, , - . Volume control ventilation
volume cycled,

26

. , (17 2).
.
( 0.7 ) (
, ). ,
, .. .
,
, .

19


( ) - /.
PEEP - (
), .
PEEP , ( - , , .), . .. Pressure support ventilation ,
. , , .. , ,
.
.

. ,
. (900 ), - 23 2. ,
, .. .
( ),
, .


,
.
, - , .
,
.. ( -2 2,0),
. .
, . .
,

20

, / . PEEP/
10 2 , -
( -),
.
, / . PEEP , - . / - .
/ , .
, , / -

25

, - , .
,
.
,
. , .
.

/ (Positive End-Expiratory Pressure /Continius Positive


Airway Pressure - /
)
- -
.

. .
+5...+ 10 2, 10...+ 15 20.
, .
Positive End-Expiratory Pressure (PEEP) - , Continius Positive
Airway Pressure (CPAP) -
. , . , . (, ).
, Pressure support.

24

.
(, ) ,
, 2


-
, - .
, .
-
, .. . ,
. , , . -

21

Pressure support ventilation .

Pressure support ventilation




. Pressure
support ventilation Drager Assist spontaneus
breathing(ASB) - .
, - .
,
. , , , . Pressure control
ventilation , .. , . ,
.. . ( ,
, , 5 /).

( ) , ,
. , , !
, , (,
). , , , ,
( , , ). Pressure support ventilation ,
, .
Pressure support ventilation(PSV),
Pressure control ventilation (PCV)

PSV (ASB) , ,
, ( PCV).

PSV -
PCV,
PCV, .. PSV , PCV.

PSV ,
PSV PCV - . (, - 30 2).

PCV, Pressure support ventilation


, .

, . - , . ,
, -

22

23