7月19日（土）12:00～13:00（PDF/1MB：2page）

第36回日本呼吸療法医学会学術総会
The 36th Annual Meeting of the Japan Society of Respiratory Care Medicine
会期：2014年7月19日（土）
・20日（日）
会場：秋田市にぎわい交流館AU／秋田キャッスルホテル／
秋田県民会館
会長：多治見公髙（秋田大学大学院医学系研究科救急・集中治療医学講座）
ランチョンセミナー3（LS3）
PEEP Titration and LUNG recruitment
using the Pressure Volume (or PV) tool.
日時
会場
座長
演者
2014年7 月19 日
（土）
12：00∼13：00
第 4 会場
（秋田キャッスルホテル4階・矢留）
藤野裕士
先生
（大阪大学大学院医学研究科麻酔・集中治療医学教室教授）
Ross C. Freebairn, MB, ChB, FCICM
（Hawke's Bay Hospital, New Zealand）
※本学術集会ランチョンセミナーはチケット制です。定員となり次第配布を終了いたしますので、ご了承ください。
なお、チケットはセミナー開始後に無効となりますので、ご注意ください。
■配布時間：7月19日（土）8：30∼
※セミナー開催当日
■配布場所：秋田キャッスルホテル 4階ロビー
共催：第36回日本呼吸療法医学会／日本光電工業株式会社
第36回日本呼吸療法医学会学術総会
PEEP Titration and LUNG recruitment
using the Pressure Volume (or PV) tool.
Webb And Tierney’s animal model in 1974 described the effect on isolated rabbit lungs of high-pressure
ventilation, (seen here) with the low level of ventilation causing no discernible damage and the higher
levels (on the right) showing severe damage. An important finding was that the application of 10 cm H20
PEEP resulted in less damage, even though the same “Damaging “ peak inspiratory pressure of 45 cm
H20 was used. It appears that PEEP protected against the high pressures of ventilation.
How then should we adjust peep? Adjustment of course is easy, simply turning the knob right or left to
create the end expiratory pressure that we want. The question is how should we adjust PEEP effectively
to improve patient outcomes?
The titration of PEEP according to some sort of compliance parameter therefore has some appeal. Over
some years the Hamilton Medical Ventilators have developed and now installed into their ventilator a
tool, the Pressure volume 2 tool (PV2) that permits an automated, repeatable generation of a Pressure
volume Loop. It achieves this by using a technique simulating a “Super syringe “, creating a slow rise in
the airway pressure, and measurement of the volume at that time. How does this help with setting PEEP?
Several methods that have been researched to determine appropriate PEEP will be explained with clinical
evidence.
Also, what about recruitment? Recruitment is the reopening of collapsed alveolar by the use of a
sustained pressure, usually above normal ventilating pressure.
At least three different recruitment manoeuvres that are currently used will be explained in this seminar.
The use of the PV tool provides great promise for ventilation of the critically ill.
共催：第36回日本呼吸療法医学会／日本光電工業株式会社
資料No. SP64-013
'14.6.MA.B.
7955

Download Report