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1067 ①COVID-19危重症患者有创机械通气的原则 Principles of invasive mechanical ventilation in critically ill patients
1068 在保障患者基本通气和氧合需求的同时如何降低机械通气相关性肺损伤在COVID-19患者治疗过程中至关重要。 It is important to balance the ventilation and oxygenation demands and the risk of mechanical ventilation-related lung injury in the treatment of COVID-19 .
1069 ●严格限定潮气量4~8mL/kg理想体重。 ·Strictly set the tidal volume to 4 8 mL/kg.
1070 通常情况下,肺顺应性越低,预设的潮气量也应越小; In general, the lower the lung compliance, the smaller the preset tidal volume should be.
1071 ●控制平台压<30cmH2O(1cmH2O=0.098kPa)、驱动压<15cmH2O; ·Maintain the plat form pressure < 30 cmH2O (1 cmH2O = 0.098 kPa) and driving pressure <15 cmH2O.
1072 ●根据ARDSnet规范进行PEEP设定; ·Set PEEP according to the ARDS’s protocol.
1073 ●通气频率18~25次/min,允许适度的高碳酸血症; ·Ventilation frequency: 18-25 times per minute. Moderate hypercapnia is allowed.
1074 ●潮气量过大、平台压和驱动压过高时,加强镇静镇痛、甚至给予肌肉松弛药。 ·Administer sedation, analgesia, or muscle relaxant if the tidal volume, platform pressure and driving pressure are too high.
1075 ②肺复张 Lung Recruitment
1076 肺复张可能改善ARDS患者肺病变的不均一性,但同时存在严重的呼吸、循环并发症。 Lung recruitment improves the heterogeneous distribution of lesions in patients with ARDS.