Gluck E, Bone R C, Eubanks D H
Rush Medical College, Chicago.
J Crit Illn. 1992 Aug;7(8):1319-28.
Potential indications for mechanical ventilation include hypoxemia unresponsive to oxygen administration, hypercapnia resulting in acidemia, and an unstable chest wall. For best results, carefully prepare the patient (both physically and emotionally) before instituting ventilation. Sedatives and local anesthesia can facilitate intubation; avoid paralytic agents unless you are experienced at intubation. The oral route is most commonly used. Once the patient circuit is attached to the endotracheal tube, reexamine the patient and double-check the inspiratory flow and I:E ratio; adjust the ventilator's settings as necessary. Monitor the patient frequently to ascertain the adequacy of alveolar ventilation and arterial oxygen.
机械通气的潜在指征包括对氧疗无反应的低氧血症、导致酸血症的高碳酸血症以及不稳定的胸壁。为获得最佳效果，在开始通气前要仔细做好患者的准备工作（包括身体和心理方面）。镇静剂和局部麻醉有助于插管；除非你有插管经验，否则应避免使用麻痹剂。最常采用经口途径。一旦患者回路连接到气管内导管，重新检查患者并再次核对吸气流量和吸呼比；必要时调整呼吸机设置。经常监测患者以确定肺泡通气和动脉血氧是否充足。
