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1、全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU呼吸机在急诊科的应用瑞思迈（北京）医疗器械有限公司医用产品市场部 吴易东email: YidongW全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine什么是移动ICU？全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine什么是移动ICU （mobile ICU）？-配备经过特殊培训的ICU水平的医务人员和必需的ICU水平的移
2、 动医疗设备的危重患者转运平台，如院内危重患者转运床、救护车 、救护直升机、固定翼救援飞机等。澳大利亚MedStar紧急救援中心 固定翼救援飞机Flying Intensivists +ICU device equipted FX plane全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine院内移动ICUPost-op recoveryICUHemodialy sesA127(2):688-9; author reply 689.Ligtenberg JJ, Arnold LG, Stienstra Y, et al. Q
3、uality of interhospital transport of critically ill patients: a prospective audit.Crit Care.2005 Aug;9(4):R446-51.全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine从国外文献看移动ICU的作用Therefore, a mobile intensive care unit must accompany the patient and must include the same monitoring capabil
4、ity and personnel available in the ICU.Determination must be made before departure concerning whether the patient will receive adequate support on a transport ventilator or will require transport with ICU ventilator.-因此，一个移动ICU应该伴随病人的转运并且应该包含在ICU 相同的监测设备.Reynolds HN, Habashi NM, Cottingham CA, et al
5、. Interhospital transport of the adult mechanically ventilated patient. Respir Care Clin N Am. 2002 8(1):37-50.全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine从国外文献看移动ICU的作用CONCLUSIONS: Mobile ICU emerges as a safe and convenient method of in-hospital transport. It allows uninterrupted
6、monitoring, immediate response to physiologic changes, and reduction in human resource consumption. Process of care is improved. Mobile ICU s potential to improve clinical outcomes needs to be tested in different environments, including the prehospital setting.移动ICU是安全和方便的院内转运方式 移动ICU对临床结果的潜在好处还需要在不
7、同的条件下测试，包 括院前急救 Velmahos GC, Demetriades D, Ghilardi M, et al. Life support for trauma and transport: a mobile ICUfor safe in-hospital transport of critically injured patients. J Am Coll Surg. 2004;199(1):62-8.全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU (MICU)用于院内转运是法规和指南要求（荷兰
8、 ） When looking at our data, transfer by MICU appears to be safe despite the high degree of severity of disease. We, therefore, conclude that the safety of the current way of transporting the critically ill is warranted and that the MICU sets a major improvement in quality of care for the critically
9、 ill. -根据本文的数据，移动ICU是安全的转运方法，尽管病人严重程度 很高 This observational study of MICU transfer shows that transfer by MICU is not associated with major deterioration in patient status and that the implementation of a transport protocol with a mobile Intensive Care Unit has led to an improvement in quality of ca
10、re on the road, compared to the former way of transfer. -没有与转运有关的病情恶化，与常规方式相比，可以改善医疗质量Janke S Wiegersma, Joep M Droogh, Jan G Zijlstra, et al. Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team. Critical Care 2011, 15:R7
11、5- 82.全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU 用于危重患者转院是法规和指南要求（荷兰）From 2009 on, interhospital transfer has been performed by a Mobile Intensive Care Unit with a specialized retrieval team according to national ICU guideline and law. -根据国家的ICU指南和法规，从2009年起，医院之间的转运将由移 动ICU及其
12、专门的医疗团队来执行Excessive deterioration in pulmonary status is not present in the ICU- transfer and has, therefore,shown improvement in the support of respiratory status before and during transfer compared to transfer by standard ambulance. -严重的肺部情况恶化没有出现在移动ICU，与标准救护车相比，在 转运前和转运中显示出更好的呼吸支持效果 Janke S Wiege
13、rsma, Joep M Droogh, Jan G Zijlstra, et al. Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team. Critical Care 2011, 15:R75-82.全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine非移动ICU医院内转运的不良事件发生Janke S Wiegers
14、ma, Joep M Droogh, Jan G Zijlstra, et al. Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team. Critical Care 2011, 15:R75- 82.危重患者循环系统： -严重低血压或 高血压 -心律失常 -心脏卒中 -死亡呼吸系统： -严重低氧血症 -支气管痉挛 -气胸 -插管脱出 -人-机对抗低温设备性能异常/故障： -缺乏ICU设备
15、性能 -不稳定 -电力故障 -氧气故障人为错误： -转运指证和时机 -非移动ICU团队 -不恰当的治疗神经系统： -烦躁不安 -颅内压升高全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU中的机械通气全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU最重要的作用-维持ICU水平机械通气 移动ICU中的危重患者大多需要机械通气和呼吸支持 维持原来相同的呼吸道护理 维持原来相同的呼吸模式、参数，甚至相同的呼吸机 ICU患者或危重患者需要
16、维持ICU水平的机械通气 -使用移动ICU呼吸机全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine何为移动ICU呼吸机或ICU+移动呼吸机？全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU呼吸机-ELISEE 系列呼吸机 具有ICU呼吸机的性能，是一台ICU呼吸机 通过ICU呼吸机的相关国际标准，如EN794-1等 电动电控呼吸机 最大峰流速应达到200L/min以上 精密的气路结构和气体动力学 具备ICU水平的呼吸模式和参数 同步性全球呼吸及睡眠医学的领导者Global leaders in sleep and respiratory medicine移动ICU呼吸机-ELISEE 系列呼吸机 具有ICU呼
