Guttmann J
Anaesthesiologische Universitätsklinik, Albert-Ludwigs-Universität Freiburg.
Biomed Tech (Berl). 1998 Apr;43(4):107-15. doi: 10.1515/bmte.1998.43.4.107.
Mechanical or artificial ventilation is the most important life-saving therapeutic instrument in modern intensive care medicine. The ventilator takes on the convective transport of the respiratory gas, i.e. delivery of oxygen and removal of carbon dioxide. The technical gas delivery system (ventilator, respiratory tubing system, gas humidifier) and the respiratory system (lungs and thorax) of the patients form a connected pneumatic system of high complexity. The respiratory system produces a mechanical impedance to ventilator output. Impedance is composed of an elastic, a non-elastic, i.e. resistive, and an inertive part. The corresponding indices describing respiratory mechanics are compliance, flow resistance and inertance. Based on the equation of motion of the respiratory system, several methods of analysing respiratory mechanics during mechanical ventilation are described. Quantitative analysis of respiratory system mechanics (a) is a prerequisite for the understanding of the complex patient-ventilator interaction, (b) provides important clinical information on pulmonary function and the course of disease, and (c) allows the physician at the bedside to adjust the ventilatory settings to the needs of the individual patient.
机械通气或人工通气是现代重症监护医学中最重要的救命治疗手段。呼吸机承担呼吸气体的对流传输，即输送氧气和清除二氧化碳。技术气体输送系统（呼吸机、呼吸管路系统、气体加湿器）和患者的呼吸系统（肺和胸廓）构成一个高度复杂的连通气动系统。呼吸系统对呼吸机输出产生机械阻抗。阻抗由弹性部分、非弹性（即阻力性）部分和惯性部分组成。描述呼吸力学的相应指标是顺应性、流动阻力和惯性。基于呼吸系统的运动方程，描述了几种在机械通气期间分析呼吸力学的方法。呼吸系统力学的定量分析（a）是理解复杂的患者-呼吸机相互作用的前提条件，（b）提供有关肺功能和疾病进程的重要临床信息，并且（c）使床边医生能够根据个体患者的需求调整通气设置。
