高流量氧疗的生理效应高流量氧疗的生理效应COIstatementTheauthorhasnoconflictofinteresttodeclare.2高流量氧疗的生理效应HighFlowaninterestingoxygenationmethod-novel-magic-gentleandmoderate3高流量氧疗的生理效应HFNCshinesduringRSIPutthebigcannulaeintoyourpatientsnoseandletrrip.AddafacemaskorNIVorwhateveryourpreoxygenationpleasure,thenpushyourmedsandlaughtoyourselfasthesaturationrisesduringapnea.Whistlesweetlyastheinternilluminateseveryinchofthesoftpalatewithgreatdetermination.Hell,goseeanotherpatientandtellhimtocallyouwhenhesgivenup.Youremember,though,thedaysofthegiants.Whenbeingregardedasaskilledlaryngoscopistmeantsomething.Whenthewordairwaymadeinternistsscatterlikemice.Whenitwasntsoeasytosavealife.http:/ therapylair/oxygenappliedtopatientathigh flowrateslair/oxygenrunthroughanasal cannulalair/oxygeniswellconditionedbysufficientwarmthandhumidification -socalledheated,humidifiedhigh-flownasalcannula(HHHFNC)therapy2-70L/min8高流量氧疗的生理效应MechanismsofactionforHFNClWashoutofnasopharyngealdeadspacelReductionofinspiratoryresistance(workofbreathing)byprovidingadequateflowlImprovedmechanicsbysupplyingadequatelywarmedandhumidifiedgaslReductioninthemetaboliccostofgasconditioninglProvisionofdistendingpressure9高流量氧疗的生理效应WashoutofnasopharyngealdeadspaceThehigh volumetric flowspouringfromasmallborecannulacausehigh velocityflowswhichcreateturbulentenergytoflush the upper airwayofexpiratorygas.10高流量氧疗的生理效应Deadspacewashoutimprovesventilationlanatomicaldeadspaceinadults30%oftidalvolumeinneonates50%oftidalvolumelchangethegascompositioninnasopharyngealspacelreducerebreathingexpiredCO2lincreasethefractionofinspiredO2lincreasealveolarventilationefficiencyMV=(VTVD)xRRPaCO2=PeCO2/(1VD/VT)PaO2=(PBO2PH2O)xFiO2PaCO2/RPA-aO211高流量氧疗的生理效应HighflowandhighvelocityincreasealveolarventilationefficiencyllikelyminimizetheinspiratoryresistanceassociatedwiththenasopharynxbyprovidingnasopharyngealgasflowsthatmatchorexceedapatientspeakinspiratoryflowlCoandaeffectoccuringinthenasopharyngealregionduringexpirationpotentiallyassistexpiratoryeffortslbringaboutadecreaseinworkofbreathingandrespiratoryratelcreatemoreturbulentenergyformoreeffectivewashoutlflushtheexpiratorygasfromtheupperairwayquicklyduringtheexhalationphaseofbreathing,whichiscriticalinpatientswithrapidbreathing13高流量氧疗的生理效应VentilatoryResponsestoHFNCMndelTetal.MechanismsofnasalhighflowonventilationduringwakefulnessandsleepJApplPhysiol,2013.114:1058106514高流量氧疗的生理效应MucociliarytransportsystemHealthciliatedepitheliumDamagedciliatedepitheliumhttps:/