l

THO MAY

1ho muy u bon phup ho tro ho hup, nho vuo muy tho do dum buo so
thong kh cho bonh nhun soy ho hup. Moc too cou tho muy u dum buo thong
kh pho nung, cu thon oxygon hou muo vu gum cong tho.
l. Al CONG VF MAY THO:
l.1. Cac Ioai may tbo: tdung co tu V Nh dong l)
I.1.1. May th the tch:
! Lou muy tho: Sorvo 900, 1-rd, Loo lL.
! Vun hunh thoo phoong thoc tho kom sout tho tch tvoomo contro), houc
phoong thoc tho ho tro koo tho tch tlMV, SlMV). 1hoong so dong cho tro >
l0kg vu ngoo on.
I.1.2. May th ap lc:
! Lou muy tho: ubybrd, Sochrst.
! Vun hunh thoo phoong thoc tho kom sout up oc tprossoro contro), houc
phoong thoc tho ho tro koo up oc tprossoro sopport).
! Muy tho up oc co oo dom u dum buo dooc tho tch kh oo thong trong
troong hop co thut thout qou no kh qoun, v tho duy u muy dooc chon cho
tro nho < l0 kg, dut no kh qoun khong bong chon.
I.1.3. May th the tch-ap lc:
! Lou muy tho: Sorvo 900C, Sorvo

, Lvtu-2, lvont 20l, our l000.

! Vun hunh thoo cu hu phoong thoc tho kom sout vu ho tro, cu hu koo tho
tch vu up oc.
1.2.4. May th kiem soat lu lng:
Lou muy tho: our-cop, Novport
Vun hunh thoo phoong thoc kom sout oo oong, khong do dooc tho tch, co tho
do dooc up oc doong tho.
l.2. Cac pboong tboc tbo:
I.2.1. Phng thc kiem soat:
Muy kom sout toun bo tun so tho, t o l/L vu up oc houc tho tch kh ht vuo:
Kom sout tho tch tVoomo Contro), kom sout up oc tlrossoro Contro).
I.2.2. Phng thc ho tr:
onh nhun to tho mot phun, muy ho tro mot phun up oc houc tho tch: Ho tro
up oc tlrossoro sopport), thong kh ngut qoung but booc dong bo tSlMV) thoo
koo Voomo houc lrossoro, tho up oc doong on toc tClAl). onh nhun kom
sout tun so tho, tho gun l/L.
1.2.3. Phng thc kiem soat ho tr A/C (Assissted Control):
Muy kom sout toun bo tun so tho, t o l/L, up oc tlrossoro Contro) houc tho
tch kh ht vuo tVoomo Contro) vu kh bonh nhun to tho qou moc trggor cu
2
dut, so kch hout muy bom thom mot nhp tho mo toong to nho nhp tho kom
sout cho bonh nhun.
ll. CHl ]NH THO MAY:
! Con ngong tho, tho khong hoo qou houc luCO
2
> 50 mmHg.
! 1hoo oxygon muo nung, luO
2
< 60 mmHg vo tho oxy, ClAl.
! Huo phuo ong ngoc, bong trong nhong go duo.
! 1ung thong kh tluCO
2
25-35 mmHg) o bonh nhun tung up oc no so.
lll. THC HANH THO MAY:

Cac bc tien hanh th may:
l. Dunh gu bonh nhun.
2. Chon muy tho vu phoong thoc tho.
3. Dut thong so bun duo vu moc buo dong
4. Doo chnh thong so muy tho cho pho hop.
5. 1hoo do bonh nhun suo tho muy.
6. Xo tr mot so vun do kh tho muy.

lll.1. at tbong so ban dao:
lll.1.1. anb gia bcnb nban:
! 1oo vu cun nung: gop chon muy, koo tho vu tho tch kh oo thong.
! onh y: do chon phoong thoc tho vu cuch dut cuc thong so.
! Khum um sung: duo hoo snh ton, tr guc, SuO
2
, pho um.
! Xot nghom: kh muo, Xqoung pho: nhum xuc dnh v tr no kh qoun, co
trun kh mung pho khong :.
lll.1.2. Cbon may tbo va pboong tboc tbo:
! Chon muy tho:
Cun nung < l0 kg houc co ton thoong pho: muy up oc.
Cun nung > l0 kg, khong co ton thoong pho: muy tho tch houc up oc.
! Chon phoong thoc tho.
lhoong thoc kom sout: ngong tho houn toun, houc dong thooc oc cho ho
hup houc cun tung thong kh o bonh nhun tung up oc no so.
lhoong thoc ho tro: con to tho, cu muy.
lll.1.3. at tbong so ban dao:
Kh but duo tho muy non chon phoong thoc kom sout tcontro) houc A/C
tussst/contro). Noo bonh nhun con to tho th dong thooc un thun houc dun co.
! 1ho tch kh oo thong tV
1
): thong thoong to 7 l0 m/kg
onh thun knh, co: V
1
= l0-l5 m/kg huy l0 m/kg " sgh ttho suo).
onh y pho tAkDS) huy tuc nghon doong tho: V
1
thup t6-8 m/kg) v so tu
bon do up oc cuo.
Huo phuo cut pho: gum V
1
toong ong vo tho tch pho b cut.
3
! 1un so tho tkk): 1hoong thoo too bonh nhun
So snh: 30-40 un / phot.
1ro nho nh: 25-30 un / phot.
1ro om: 20-25 un / phot.
1ro on: l6-20 un / phot.
Mot so troong hop tro so snh soy ho hup khong dup ong vo koo tho thong
thoong, tu Khou Ho soc so snh co up dong tho tun so cuo 60 80
un/phot.
! 1ho tch phot tV mn): V mn = V
1
x kk tt / phot)
Chon tho tch phot thup o bonh nhun bonh pho tuc nghon houc hun cho,
tho tch phot cuo o bonh nhun pho nuo cun tung thong kh kom sout.
! Loo oong kh tlov-ruto): Chon ov-ruto thoong gup 3 - 4 un tho tch
phot: So snh: 3-6 L/phot, tro nho: l0-l5 L/phot, tro on: 30-40 L/phot. Mot
so muy tho co ov-ruto to dong khong cun doo chnh.
! 1ho gun ht vuo t1) vu t o tho gun ht vuo/tho ru tl/L)
1ho gun ht vuo to thoo 0,5 guy.
1 o l/L bnh thoong u l/2. 1 o l/L koo du tl/3 l/4) trong cuc bonh y
tuc nghon doong tho. 1 o l/L duo ngooc tl/l,5 don l/l) trong cuc bonh y
co shont pho cuo nho bonh mung trong, AkDS.
! Ap oc ht vuo tlll): Ch dut trong cuc phoong thoc tho up oc.
Dut lll kho duo bung vo up oc do dooc kh bop bong co hoo qou houc
but duo vo up oc thup khoung l0 cmH
2
O tung dun on to to cho don kh
ong ngoc bonh nhun nho doo trong th ht vuo vu V
1
dut yoo cuo, thoong
lll khong qou 30 cmH
2
O.
! Ap oc doong coo ky tho ru tlLLl):
1hong thoong dut 2-4 cmH
2
O do trunh ngoy co xop pho.
Dut lLLl cuo 5-l0 cmH
2
O trong nhong bonh y gum compunco tAkDS).
1rong cuc bonh y tuc nghon doong tho kh xuc dnh co uoto-lLLl noo >
6cmH
2
O, dut lLLl o 75% moc uoto-lLLl, noo # 6cmH
2
O, dut lLLl =
4cmH2O
! Moc trggor sonstvty: 1rggor up oc thoong dut o moc -2 cmH
2
O. lov
trggor thoong dut o moc l-2 t/ph.
! Nong do oxy kh ht vuo tlO2): bung moc lO
2
ooc oong kh bop bong co
hoo qou houc lO
2
40-60%, ngou tro bonh nhun tm tu nung dut lO
2

l00%, suo do gum dun go SuO
2
vuo khoung 92-96%.
Tbong so cnb tban kinb, co
Ton tboong
pboi
Tac ngbcn
doong tbo
lhoong thoc kom
sout houc A/C
1ho tch houc up
oc ttro on)
Ap oc ttro nho)
Ap oc Ap oc
4
1un so Nhp tho thoo too Nhp tho thoo
too + 5-l0
Nhp tho thoo
too
lO
2
bun duo t%) 40 - 60 l00 l00
1ho tch kh oo
thong tV
1
) m/kg)

l0 - l5

6 - 8

6 - 8
Ap oc ht vuo
tcm H
2
O)
l2 - 20 l5 - 25 l5 - 25
1 o l/L l/2 l/2 - l/l l/2 - l/3
lLLl tcmH
2
O) 2 - 4 4 - l0 75% uoto lLLl
lll.1.4. at cac moc bao dong
! Moc buo dong tho tch:
1ho kom sout: moc buo dong tho tch bung " 20%.
1ho ho tro: moc buo dong tho tch bung " 30%.
! Moc buo dong up oc:
Moc buo dong up oc cuo: tron moc up oc dut 5-l0 cm H
2
O houc khong
voot qou 40 cm H
2
O.
Moc buo dong up oc thup: 5-l0 cmH
2
O.
! Moc buo dong lO
2
: " 5%
! uo dong ngong tho: l5-30 guy
lll.2. ico cbnb cac tbong so:
Moc dch doo chnh thong so muy tho u nhum dou gu tr kh trong muo bonh
nhun vo moc bnh thoong vo lO
2
< 60% vu lll < 30 cmH
2
O.
Ngoycn tac dico cbnb tbong so may tbo:

Tbong so FaO
2
FaCO
2

$ 1ho tch kh oo thong $ %
$ Ap oc doong tho $ %
$ 1un so tho $ %
$ lO
2
$ Khong thuy do
$ 1ho gun ht vuo $ Khong thuy do
$ lLLl $ Khong thuy do
|o ton doo chnh ro oun nung do dou don tnh mung bonh nhun. Mo
un ch non doo chnh l thong so.
1hoo do vu doo chnh cuc thong so toy thoo dup ong um sung vu kh
trong muo suo 30 phot. 1rong troong hop kho doo chnh, cun tho kh muo
5
nhoo un, non dut cuthotor dong much do uy muo muo xot nghom kh
muo.
lll.2.1. ico cbnb FaO
2
:
Moc too: go luO
2
o moc 80 l00 mmHg houc SuO
2
92 96%. 1roong
hop soy ho hup cup nung nho AkDS ch cun luO
2
& 60 mmHg houc SuO
2
&
90%.
Ngoyon tuc: Khong non tung lO
2
qou 60%, l/L duo ngooc qou l/l huy lll
qou 30 cm H
2
O noo con thong so khuc co tho doo chnh thuy tho do dut
moc too doo tr.
Suo kh co kot qou kh muo houc SuO
2
tro vo tr so bnh thoong: gum lO
2

do go lO
2
< 60%. Noo phu cun lO
2
> 60% so tung lLLl mo un 2
cmH
2
O cong oc gum lO
2
xoong dun don 60% vo luO
2
> 70 mmHg, moc
lLLl to du un toun u l0 cmH
2
O. Noo chou cu thon luO
2
o moc lLLl to
du, so dut l/L = l/l,5 - l/l. lO
2
ch dut > 80% noo khong con bon phup
nuo do tung luO
2
on.
lll.2.2. ico cbnb FaCO
2
:
Moc too go luCO
2
khoung 35 45 mmHg, ngou tro troong hop soy ho
hup mun luCO
2
co tho cuo hon vu troong hop tung thong kh do doo tr
tung up oc no so luCO
2
o moc 25 30 mmHg.
Kh luCO
2
tung > 45 mmHg kom pH muo < 7,2: tung thong kh bung cuch
tung tho tch kh oo thong houc tung tun so tho. Ngou tro troong hop bonh
y co thut pho qoun xom u l/L, non dut tho gun tho ru koo du tl/L = l/3).
Kh luCO
2
gum < 35 mmHg, thoong do dut tun so tho cuo houc do bonh
nhun to tho. Xo tr: noo bonh nhun to tho tot, xom xot khu nung cu muy,
noo bonh nhun to tho nhong um sung vu kh muo khong on dnh tdo stross,
do duo, do toun choyon hou ) cun cho thooc oc cho ho hup thom, noo do
dut tun so tho cuo so gum bot tun so tho thoo cong thoc.
Doo chnh luCO
2
thoo cong thoc:
V
1
mo = tluCO
2
do dooc x V
1
bun duo) / luCO
2
mong moon.
Houc: kk mo = tluCO
2
do dooc x kk bun duo) / luCO
2
mong moon


6
too do dico cbnb FaO
2
:























Dut thong so bun duo:
lO
2
60%
lLLl 4 cmH
2
O
lll 25 cmH
2
O
luO
2
> 70 mmHg tSuO
2
> 92%)
Cum lO
2
dun cho don tr so thup
nhut mu vun go luO
2
> 70 mmHg
1ung lLLl mo 2 cmH
2
O tto du l0
cmH
2
O) cho don kh luO
2
> 70 mmHg
Dut l/L = l/l,5 - l/l suo cho luO
2
> 70 mmHg
1ung lO
2
don 80% go luO
2
& 60 mmHg
houc SuO
2
& 90%
1ung lO
2
don l00%
(+)
(+)
(+)
(-)
(-)
(-)
(-)
7
lll.3. Cac dico tr| kbac:
lll.3.1. Dinb doong:
Kh but duo tho muy thoong noo un tnh much. 1hunh phun dnh doong
cun co pdo, khong non cong cup toun bo nung oong bung Cocoso do
hun cho tung

CO
2
.
Kh bonh nhun on dnh: noo un qou sondo du duy houc noo un tnh much
mot phun, cho do sou dnh doong kom bot l0% xo y mon houc Lnuuc
25%, chu nho bou un, nho got chum khoung l-2 go.
lll.3.2. Mo kb qoan: ch dnh mo kh qoun o bonh nhun tho muy du nguy o
tro om con bun cu. 1ho dom mo kh qoun ch dooc dut ru suo kh tho muy to
7 l0 nguy. Lo dom cou mo kh qoun u do chum soc, do hot dum, gum
khoung chot nhong phu dong ong no kh qoun bung nhou co bong chon do
trunh thout kh vu hon nuy vo nhong ton bo vo ky thout chum soc vun cho
phop hot dum qou no kh qoun do dung. 1hoc to, nhoo troong hop vun co tho
gop tho tron l thung qou no kh qoun, mu bon chong soo hop hom xuy ru.
Kh co bon chong soo hop th phu mo kh qoun.
lll.3.3 Cbam soc bcnb nban tbo may:
Num duo cuo
Xouy tro mo 2 go.
Hot dum.
Vut y tr oo ho hup vu vun dong.
lll.4. Tbco doi va dico tr| cac bicn cbong:
lll.4.1. Tbco doi:
! Lum sung:
Duo hoo snh ton, SuO
2
mo l5 phot trong go duo. Suo do noo on mo l-2
go. oun sut so nhup nho ong ngoc vu ngho pho um. Noo pho um gum
mot bon cho bot no kh qoun suo, trun kh mung pho houc xop pho.
onh nhun dup ong tot: num yon, du nom hong, khong chong muy, duo
snh hoo on, SuO
2
92-96%, kh muo trong go hun bnh thoong.
! Cun um sung:
Kh trong muo suo 30 phot - l go do doo chnh thong so. Suo do noo bonh
nhun hong huo, much, hoyot up, SuO
2
bnh thoong th ch cun thoo do SuO
2

vu lCO
2
coo th tho ru bung cupnomotor.
X qoung pho: kh ngh ngo co bon chong trun kh mung pho houc bo
nhom pho.
lll.4.2. Cac bicn cbong va cacb xo tr:
! Doo tr chong muy:
Duo hoo: ho suc sou, tu tm, vu mo ho, tho co om ngoc, tho ngoc bong
ngooc choo, much nhunh, hoyot up cuo...
8
Ngoyon nhun: bonh nhun to tho do hot tuc dong houc khong do oo thooc
un thun, dun co houc no kh qoun nghot, vuo suo, cun ong, trun kh mung
pho, xop pho. Houc do dut cho do tho houc cuc thong so chou pho hop.
Xo tr: tuch ro kho muy vu bop bong vo lO
2
l00%, hot dum, doo chnh
thong so cho pho hop, dong thooc un thun, dun co. 1runh dut moc trggor
tron 4cm H
2
O do oc cho nhp tho.
Loo oong thooc un thun, dun co t1M):

Tbooc Tboi gian tac
dong tphot)
tico dao
tmg/kg)
tico doy tr
tmg/kg/go)
An tban: Duzopum
Mduzoum
Morphn
l5-60
30-40
240-300
0,2-03
0,05-0,l5
0,2-0,4
0,l-0,3
0,05-0,l

Dan co: Vocoronom
Atrucorom
luncoronom
30
30
60
0,l-0,l5
0,5
0,l-0,l5
0,05-0,l
0,5-l
0,05-0,l
Kot hop Duzopum houc Mduzoum vo Morphn thoong dooc so dong: pho
hop Mduzoum 0,05-0,3 mg/kg vu Morphn 0,l-0,2 mg/kg but duo tuc dong suo
l,5 phot vu tho gun tuc dong to l-5 go. Morphn: chong ch dnh trong troong
hop soc.
! 1oot ong no kh qoun: Do co dnh ong khong tot.
onh nhun tm tu, khong co nhp tho cou muy, muy buo dong tho tch tho ru
thup. Xo tr: dut u ong no kh qoun mo.
! 1uc nghon ong no kh qoun: Do gup ong, cun ong, nghot ong no kh qoun
do dum, ong no kh qoun suo. Duo hoo: bot rot, muy buo dong up oc
doong tho cuo. Xo tr: doo chnh u ong no kh qoun, hot dum. Noo cun,
dut u ong no kh qoun mo.
! 1run kh mung pho: dut up oc huy tho tch kh oo thong qou cuo, oc cho
ho hup khong tot, chong muy. Duo hoo: dot ngot tm tu, vut vu, ong ngoc
mot bon nho cuo hon, pho um ngho gum huy mut mot bon, co tho kom trun
kh doo du. Xo tr: Xqoung pho, dut dun oo kh mung pho cup coo, doo
chnh u cuc thong so cho pho hop.
! Xop pho: no kh qoun suo, nghot dum, khong xouy tro thoong xoyon. Duo
hoo: pho um gum huy mut mot bon. Xo tr: Vut y tr oo, hot dum, dun oo
thoo to tho, xouy tro bonh nhun mo 2 go.
! Vom pho bo nhom: txom phuc do nhon trong bonh von).
lV. CAl MAY:
lV.1. |nb ngbia:
Lu qou trnh tup cho bonh nhun tho muy co tho tho u bnh thoong khong cun
ho tro ho hup.
9
lV.2. ico kicn can tbict cbo bcnb nban cboan b| cai may:
l. onh ngoyon guy soy ho hup du dooc on dnh.
2. On dnh vo tnh trung um sung, cun um sung:
- 1r guc cu thon tot, houc khong con gong gut.
- Snh hoo:
! Nhp tho : 1o tho doo, oc tho tot, khong tho koo ngoc bong nghch
choo.
! Much, hoyot up on dnh
! Nhot do < 38
o
C
- lhun xu ho do munh
- lt dum nhot, dum trong
- Khong thoo muo, Hct & 30%.
- SpO
2
& 95% vo lO
2
# 40%
- lLLl # 4 cmH
2
O, lll # l8 cmH
2
O
- Kh muo: lO
2
& 80mmHg/lO
2
# 40%, lCO
2
= 35- 40mmHg
- Xqoung pho: cu thon, t houc khong con thum nhom
3. 1nh trung dnh doong tot, noo un qou sondo du duy dong nup tot.
4. Du ngong tut cu cuc thooc gun co, un thun t nhut 2 go.
lV.3. Cacb tboc cai may:
l. Cop tho tho gun ngun < 48 go: 1up tho qou ong t1) 30 phot
- Noo tnh tuo, oc tho tot, SuO
2
> 95%, kh muo suo 30 phot bnh thoong '
Co tho rot no kh qoun nguy khong qou gu doun cu muy
2. Cop tho tho gun du & 48 go ' ton hunh cu muy:
2.l. onh thun knh trong oong houc thun knh co:
- Cu muy qou ong t1):
! 1on hunh vuo boo sung
! Loo oong oxy 3 - 6 t/ phot
! 1ho gun tho ong t1) : but duo t suo tung dun on
Nguy tho nhut : l5 phot mo 4 go
Nguy tho hu : 30 phot mo 4 go 1o 8h 20h
Nguy tho bu : l go mo 4 go
Nguy tho to : l- 2 go mo 4 go cu nguy vu dom...
Kh bonh nhun to tho trong 24 go so ton hunh rot NK.
! 1rong kh bonh nhun tho ong t1):
lhu o cunh goong thoo do vu dong von bonh nhun
1hoo do bonh nhun co cuc duo hoo suo phu cho tho muy u nguy:
- Nhp tho tung t& 20% thoo too)
- Nhp tm tung
- Hoyot up tung huy gum
- Co koo on soon
l0
- Vu mo ho, bot rot vut vu
- SuO
2
< 90%, tm tu
Neu benh nhan on nh co the cho th thi gian lau hn d tnh
! Do du vu khoung cuch cou tho qou ong t1) toy thooc tong bonh
nhun
! |o dom: Don gun , do thoc hon, khong ton kom
! Khoyot dom : Do ho doo doong thoo do vu tup cho bonh nhun
2. 2. onh y tu pho: Cu muy qou lrossoro Sopport / ClAl
! Cu muy qou prossoro sopport:
- Nhp tho do bonh nhun to kom sout
- Ap oc ho tro mo nguy gum dun toy soc co cou bonh nhun bun
duo l2 - l5 cmH
2
O, gum dun l-2 cmH
2
O mo 2- 6go cho don kh
con khoung 6-8 cmH
2
O co tho choyon qou tho ClAl qou no kh
qoun.
! Cu muy qou ClAl
- un duo cho ClAl qou no kh qoun.
- Ap oc 4-6 cmH
2
O, lO
2
bung houc cuo hon lO
2
dung tho muy 5-
l0 %
+ Noo bonh nhun to tho yoo, vut vu, vu mo ho, tm tu ' cho tho
muy u
+ Noo bonh nhun tho tot: Choun b rot no kh qoun vu tho ClAl
qou mo
* kot no kh qoun:
! onh nhun cun tom Doxumothusono 0,6 - lmg/kg/nguy t1M) tchu
3 un) l 2 nguy trooc kh rot NK.
! kot no kh qoun vuo boo sung
! Ngong co sou guvugo trooc do t nhut 3 go
! onh nhun cun num duo cuo.
! Hot dum qou no kh qoun, qou mo mong trooc kh rot no kh
qoun
! Xu bong chon t noo co )
! op bong vo lO2 =l00 % 4-6 nhp tho
! kot no kh qoun, buo bonh nhun ho munh trong kh rot ru.
! 1ho ClAl huy oxy suo kh rot no kh qoun.
! 1hoo do bonh nhun, noo co duo hoo kho tho thunh qoun : tho rt,
co rot om tron oc vu on soon ( kh dong Adronun 2 5m /un
! 1op toc Doxumothusono do 3 nguy
! Xouy tro bonh nhun thoong xoyon
! 1up vut y tr oo ho hup
1runh bon chong tuc dum,
xop pho duc bot o bonh
nhun bonh y thun knh co
ll
lV.4. Ngoycn nban tbat bai coa cai may:
1 . Benh nhan t th yeu, khong hieu qua:
! Cun ngoyon chou doo tr trot do
! Dnh doong kom
! onh y d kom: soy tm, thoo muo, sot, nhom trong bonh von do tho
muy.
2. Tac am, xep phoi:
! 1ung tot dum do vom pho bonh von.
! Ho khong hoo qou do soc co con yoo
! Xop pho don rong do tuc dum so um N do thut bu cu muy
3. Phu thanh quan sau rut noi kh quan:
! Do gop tho tho gun du + dut u no kh qoun nhoo un
! 1hooc: Doxumothusono pho hop Adronun kh dong
! Noo thut bu dut NK u, cho mot gu doun suo so cu muy u
! Noo thut bu & 2un rot NK: ho chun 1MH xom xot ch dnh so, mo
kh qoun
4. Viem phoi benh vien cha ieu tr hieu qua.

Van dc Moc do cbong co
Doxumothusono co tuc dong gum pho no thunh
qoun o bonh nhun suo rot NK
l
Cochruno 2000
Chong co cho thuy opnoprno kh dong co tuc
dong gum pho no thunh qoun suo rot NK o
tro on.
l
Cochruno 2000
VD/V1 u gu tr ton oong so thunh cong huy
thut bu cou rot no kh qoun o tro om
ll
Crtcu Curo Modcno
2000
kot ong NK som vu tho ClAl o bonh nhun
tnh, hop tuc, to tho dom u nhoo kot qou tot
ll
Crtcu Curo Cncs
l998

l2
t O CAl MAY THO


lF klF N CAN THlFT CHO FNH NHAN CHA N ] CAl MAY:
l. onh ngoyon gu y soy ho hup du doo c o n dnh. )
2. On dnh vo tnh trung um sung, cun u m sung:
- 1r guc cu thon to t, hou c khong con gong gu t. )
- Snh ho o:
! Nhp tho : 1o tho do o, o c tho to t, ngoc bong nghch choo t-) )
! Mu ch, hoyo t up on dnh )
! Nho t do < 38
o
C )
- lhun xu ho do munh )
- lt du m nho t, du m trong )
- Khong tho o mu o, Hct & 30%. )
- SpO
2
& 95% vo lO
2
# 40% )
- lLLl # 4 cmH2O, lll # l8 cmH2O )
- Kh mu o: lO2 & 80mmHg/lO2 # 40%, lCO
2
= 35- 40mmHg )
- Xqoung pho : cu thon, t houc khong con thum nhom )
3. 1nh trung dnh doong tot, noo u n qou sondo du duy dong nup to t. )
4. Du ngong tut cu cu c thoo c gun co, un thun t nhu t 2 go . )

TlFN HANH CAl MAY TH :
1ho c hon vu o boo sung t12-16) ) Nhn un co 9g ) 1o tho N 45
0
)
Ho t su ch du m nho t ) gu m duo ) Cu thch & trun un )
lhoong phup: SlMV ) ClAl ) Ong 1 )
lS: l.SlMV: lLLl: lO2:
1ho
do m
/ / / / / / / / Nhun xo t
1m tu
M
HA
N1
SuO2
Vt
Vmn
l/Vt
DK
oyot dnh kot qou : co tho ro t no kh qoun ) t+) top to c cu mu y ) t-)

l3




A NH GlA kT NO l kHl QA N:
- Mu ch, hoyo t up on dnh )
- SpO
2
& 95% vo lO
2
# 40% )
- lLLl # 4 cmH2O )
- lS # 5 cmH2O )
- l/Vt < l00 )
- N1 # 30 )
- Vt & 5m/kg )
|YL1 DlNH k| 1 NO l KHl |A N: co ) kho ng )

DA NH ClA SA| k|1 NOl KHl |A N:
- Mu ch, hoyo t up on dnh )
- N1 # 30 )
- Co ko o, tm tu t-) )
- SpO
2
& 95% vo lO
2
# 60% )
- lLLl # 6 cmH2O )
|YL1 DlNH DA1 LA l NO l KHl |AN: co ) kho ng )