Features
Features:

Product Tour >

Edraw AI >

Paid Plans:

Individuals >

Business >

Eduaction >
Resources
Blog

History

How-tos & Tips

Discovery

Biography

Business Analysis

Examples

AI concept Map

Free AI Mind Map Generator

Onenote Mind Map

Bcg Matrix Examples

Nike Marketing Strategy

Unilever SWOT Analysis

Make Mind Maps in Google Docs

Guide

FAQs

What's New

Resource Center
Templates
All Templates

Brain Storming Templates

Strategy and Planning Templates

Project Management Templates

Product Management Templates

Human Resources Templates

Agile Workflow Templates

Marketing Templates

Education Templates

Fun and Games Templates

User Gallery
Download
Pricing
Enterprise

MindMap Gallery Monitoring and clinical application of respiratory function

Monitoring and clinical application of respiratory function

The monitoring and clinical application of respiratory function in anesthesiology includes the main purpose of respiratory function monitoring, respiratory system physiology, respiratory function monitoring, etc.

Edited at 2024-01-18 17:59:32

PlotWizard

Recent works View more works>>

Monitoring and clinical application of respiratory function

PlotWizard

Recent works View more works>>

Recommended to you
Outline

Monitoring and clinical application of respiratory function

The main purpose of respiratory function monitoring

Assess the patient's respiratory status

Diagnose the type and severity of respiratory dysfunction

Understand the dynamic changes in respiratory function of high-risk patients to facilitate disease assessment and adjustment of treatment plans

Evaluate the effectiveness of respiratory treatments

Ultimate goal: prevent hypoxemia and hypercapnia

Respiratory system physiology

breathe

Concept: It is the process of delivering oxygen to tissues throughout the body and expelling carbon dioxide

Three basic links

Pulmonary breathing (external breathing)

Pulmonary ventilation: the process of gas exchange between outside air and the lungs

Pulmonary ventilation: The process of gas exchange between the alveoli and pulmonary capillaries

Transport of gases in the blood

internal respiration or tissue respiration

The gas exchange process between blood, tissues and cells

hypoventilation

restrictive hypoventilation

Refers to alveolar hypoventilation caused by limited alveolar expansion during inspiration.

reason

Respiratory muscle activity disorder

Decreased thoracic compliance

Reduced lung compliance

Pleural effusion and pneumothorax

obstructive hypoventilation

Refers to ventilation disorders caused by airway narrowing or obstruction

Respiratory function monitoring

General monitoring

state of consciousness

Mild hypoxia - excited, multilingual, oriented

Severe hypoxia - confusion, drowsiness, coma

Skin and mucous membrane color

Reduced hemoglobin - cyanosis (except Hb<50g/L)

CO poisoning - cherry red

respiratory movement

frequency, amplitude, form

Chest auscultation, percussion, palpation

Ventilation function monitoring

static lung capacity

4 basic volumes

Tidal volume (VT) Inspiratory supplementary volume (IRV) expiratory supplementary volume (ERV) Residual volume (RV)

4 functional volumes

Vital capacity (VC) deep inspiratory volume Functional residual volume (FRV) total lung capacity (TLC)

dynamic lung volume

Minute ventilation (VE)

Total amount of air inhaled or exhaled per minute at rest

=Tidal volume VT×Respiratory rate RR

Alveolar ventilation (VA)

The amount of fresh air inhaled into the alveoli per minute

=(TV-Dead Cavity Amount)×RR

VA reflects the true gas exchange capacity of the lungs

Dead space

Physiological dead space/tidal volume (VD/VT)

Physiological dead space includes anatomical dead space and alveolar dead space

Maximum ventilation volume (MVV)

The maximum volume of air that can be exhaled or inhaled per minute while trying to breathe deeply and quickly

Evaluation of ventilatory reserve function

Forced vital capacity (FVC)

After the maximum inhalation, the maximum volume of air that can be exhaled at the fastest speed and with the greatest force

Forced expiratory volume (FEV)

Calculate the volume of air exhaled per unit time and the percentage of forced vital capacity occupied based on FVC

Maximum mid-expiratory flow (MMEF)

Concept: Calculate the average flow rate between 25% and 75% of forced expiratory vital capacity from the FVC curve.

Mainly affected by the diameter of the small airways, the decrease in flow reflects the obstruction of the small airways

Early detection of obstructive ventilatory dysfunction

ventilation function

blood oxygen monitoring

Arterial oxygen partial pressure (PaO2) and transcutaneous oxygen partial pressure (PtcO2)

Commonly used clinical indicators, reflecting arterial oxygenation and diagnostic criteria for hypoxemia

Arterial oxygen saturation (SaO2) and pulse oximetry (SpO2)

The latter is commonly used clinically, reflecting the various aspects of oxygen transport to tissues.

Mixed venous oxygen saturation (SvO2)

An indicator of the balance between oxygen supply and oxygen consumption

carbon dioxide monitoring

Arterial partial pressure of carbon dioxide (PaCO2): the pressure produced by physically dissolved CO2 molecules in the blood

Transcutaneous carbon dioxide partial pressure (PtcCO2): Generally higher than PaCO2 5~20mmHg

End-tidal carbon dioxide partial pressure (PETCO2)

Exhaled breath mass spectrometry

The significance of PETCO2 waveform changes

Elevated PETCO2

PETCO2 suddenly decreases

Sudden reduction to 0: respiratory circuit disconnection, endotracheal tube prolapse or accidental entry into the esophagus, sampling tube obstruction, etc.

PETCO2 decreases exponentially, seen in sudden drops in blood pressure, pulmonary embolism, cardiac arrest, etc.

A sudden decrease, but not reaching 0, may be caused by a twisted endotracheal tube or partial disconnection of the circuit.

CO2 waveform: continuously measured PETCO2 displayed on the monitor

Gas exchange efficiency monitoring

Alveolar air-arterial blood oxygen partial pressure difference

Understand the pathophysiological changes of hypoxemia and determine the cause of the disease

Oxygenation index (PaO2/FiO2)

Ventilation-perfusion index and respiratory failure index reflect oxygen exchange status

Oxygenation index <300mmHg, indicating pulmonary respiratory dysfunction

Intrapulmonary shunt (Qs/Qt)

Reflects whether the ratio of alveolar ventilation and blood flow is normal

In pathological conditions such as COPD, ARDS, congenital heart disease, right-to-left shunt, pulmonary edema, and atelectasis, the ratio of alveolar ventilation and blood flow significantly decreases, functional shunt increases, and Qs/Qt increases significantly, reaching 30 to 50% in severe cases.

Diffusion function measurement

Diffusion capacity (DL)

The amount of gas that can pass through the alveolar membrane under unit partial pressure difference (mmHg or kPa) within a certain period of time (1 minute)

It is a physiological index that measures the function of the alveolar membrane.

clinical significance

Reduce: extensive damage to lung tissue, pulmonary edema, pulmonary fibrosis, asbestosis, etc.

Increased: polycythemia, intracardiac left-to-right shunt

Oxygenation function monitoring

Ventilation function monitoring

blood gas analysis

Small airway function monitoring

Closing volume (CV)

The amount of air that can continue to be exhaled when the small airways in the lower part of the lung begin to close during one exhalation from the total lung capacity

CV/VC: Increased due to small airway obstruction or decreased elastic recoil of the lungs. Seen in long-term heavy smoking, bronchiolar infection, COPD, and interstitial pulmonary fibrosis

Maximum expiratory flow-volume curve (MEFV): maximum expiratory flow at 50% of vital capacity and maximum expiratory flow at 25% of vital capacity. Measured/estimated <50% is abnormal.

Dynamic lung compliance/static compliance ratio <0.8 indicates small airway disease

Respiratory mechanics monitoring

airway pressure

airway resistance

Chest and lung compliance

Pressure-Volume Ring (P-V Ring)

Flow rate-volume ring (F-V ring)

The normal work of breathing (WOB) is 0.4-0.6J/L

Clinical application

Preoperative respiratory function assessment and respiratory treatment