Japanese niv

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Japanese niv

  1. 1. 479 12.-,+* Noninvasive Positive Pressure Ventilation!NPPV"$#%&#' 12.-,+* NPPV $#%&#'/0()* .2~ x0 Em#xT9oŽ3j˜/¢)-*"$ . 2#Ia6b$ q^ Ni#Š–x:/:“G>;ˆ8$ pr œ7#R Ž3<O 4Ž3cZ8$ pF 5_#xT‘ G>;!&,+'"/¢)-*"G>;ˆ8!`|[¢8$ žQ ¡1#…•x:/¢)-*"xfŽ3—k8$ cV‚=L#R Ž3<O …A/¢)-*"G>;8$ CX w‹#v‚sQŽ3j˜/¢)-*"$ ™uDv¥#‚£Y(&)-*"$ B† MŒ#J ‡oŽ3G>;!&,+'"ˆ8$ g› h#R Ž3<O „SVŽ3$ ¤r n‹#[/8x:@?/:$ !U W#v‚sQŽ3j˜/¢)-*"$ {‚ eP#Š–/8x:—k8!`|[¢]$ yK Œ‹#J ‡oŽ3G>;!&,+'"ˆ8$ € ¦#Aƒx:/:“’tŽ3Ÿ:¢”“$ 0 zn#R Ž3<O ‰AƒŽ3G>;8$ l0 PW#H%šŽ3G>;)-*"$ ~yrd‹#[/8x:@?/:$ }‚ ¦X#R Ž3<O …AŽ3G>;8$
  2. 2. 480 .¬œŠÄ 44(6) !2006" ' $ ( & .C¬œ•Š NPPV [YktYx¾ê{‚ÿ ù€ ¨ë ä8-šÔ2%ß8!ÛX@¶DPR:EšÔ2O VI ’Îi%eD–>1C-!ïL{‚ŠOïLˆ B@,TG!¹Ð#DF4ŽøÚç2³UT!:E «æE|¦ 7†2"KR![YktYx2¾ê7TS"6E[Y ZmixbwnvF:E¥žE˜I!i`YxDP ktYxDFä8-šÔE:›Aª½EO¯éE evi- R I'VI D<5?-S" dence E܉A-. 2 =EM2,S"K;![Yk z„DÉ9çØ&F!ZmixbwnvD”Y8? tYxÊ÷EO¯éN7†7TS"Noninvasive Posi- :E,PV{‚Š@¤(8;NE@,S" tive Pressure Ventilation(NPPV)D0-?N!Eé A ³.6AV 4çØ9S >ºé2˒Eéôy!ã©é2èÏCBD0-?! B ³.6AVçØ9S 4ŽøÚç2³UT!NPPV EOQé2U8? C çØ9S¸Ÿ2F<3R8C- -S2!J1E˒DPS¬œ8ñE¬œ“TA8? D ³UC-P.D‘MQTS F!"E¦‹F+QT?-C-"C×F!6EP. + NPPV [YktYx{‚ŠA8?çØ9S" Cªá@E!.C¬œ•ŠDPS NPPV E[Yk A4DZmixbwnv2!-ßµ@NçØ@3S tYx@,S2!NPPV F*/7T?ÖM?OQ@ ,PD=-?F+A8?C[YktYx{‚ŠA8? ,S;M!šÔE:›VÅS|FN,R!*/D”9 çØ9Sp%V95?-S"6TQFC=!K;Œ S´JVó[A8?í5!CSE[YktYxDò' [EŒ´JEÙZD(wnv I'VI&çØ& A'D)A 9S;<FŒ[A8?±ê8;" 8?™8?-S" C[YktYxñ=F-²)PRÓ37TS2!Œ C0!Zmixbwnv!çØ&F,4K@ªÇ$ ˒E NPPV D=-?EZmixb!çØ&Výã @ENE@,R!·®E¥žDPR:E,PF?…9 D!Œ[EÙZELŠÄD¡¼9S6AAC<;" S‡1é2,S6AVV|7T;-" !6+*,.*1&"#)0-/5#%324 K;!æ°¬œ“TD”9S~WÆ­EKúCB2 C[YktYx@F!¸ŸA8?»Q7T;«$E ,R!K;!ÐD—E¬œ“T@F!ÈWAåD”8! ¥žDZmixbwnv0PH:E,PD=-?Eç CæE|À026R@,SA7TS2!CæE|À Ø&Vz„D8M9" 02‡1@,SEFN 25* ð®A-UT?0R! I abhphXgwms%!reWluab æ°¬œEýÂà£CBÒ<C͊#^xdx_b2 II 1 =zÞEtxfq…4ŽÃ§ /QT?-C-"NPPV D0-?Füû2P}@, III 5txfq…4ŽÃ§DPS SA!ÌéD¢5SHN,R!âÑ#æ°¬œz IV <샏#¥ž(^o%j¥žOÛXøÝ¥ž ÞDö4EKú2,SAÁUTS2!:E¿QD, DPS) ;<?!’Î#’ΈõIEÒ<CîGA|À0E V ™Õ¥ž(ÛX@¶O]%b#au%c)DP 6Ré2,R!ÈWAå!ub“TEKúCBDN S Ò<þ|VFQ.6R2,SAÁUTS"
  3. 3. 481 NPPV%’|uŒ›HU[ž•&;9AD9F ™ q „   3"bReJz3]‚…G 1"NPPV )54.]‚d“ƒ 4"Ws‚N 2"NPPV )54.–‚d“ƒ 5"}c‚t 3"NPPV 0lš+76€hdY1C$ 6"^Sˆx A 7"€hdŠ2k,/3nM”• 4"]‚d“ƒ2(*6 NPPV 3Ž” 8"˜L“ƒ2']‚d“ƒ • 9"ARDS! ALI!vzN 5"–‚d“ƒ2(*6 NPPV 3Ž” B"–‚d“ƒ • 1"i‡‚U[{P 6"gO2XŸ-6Km1@DBE3‰w! 2"COPD%–‚Z& IƒVœ 3"– ‚ } “ ƒ 2 ( * 6 ? : $ F#> 7"NPPV Ž2XŸ-6oj @$<>d 4"‘—‹U[zf` Q   5"~a#_rT A"]‚d“ƒ 6"yp 1"COPD 3]‚…G 7"Že3=8 2"¡†
  4. 4. 482 ?°›†Ë 44&6'!2006" Noninvasive Positive Pressure Ventilation&NPPV']ZioZq ,G A!1?50F@ 4!/7?E+ 1!COPD %1?A) œì°›NøX/8T“ÐìD~AG!KBYCFà œì°›NøE-2T NPPV E-*@!ZìSÃì pAbfpZi`P_}hë`/Çe5UT<NE_} Dώ&chronic obstructive pulmonary disease : COPD' hëã%E•T";F<N!NPPV EQSú’X‡K8 FœìürGÂO!1Fª5/D5U@*T"GOLD T3B/!QS|<ôDCF»RàEîlX®R7Ê &Global Initiative for Chronic Obstructive Lung Dis- XlX®R83BE?D/T3B/˜$5UT"¯Ì3 ease'AG!NPPV Gú’F‡K!ú’çµ°›’kE A NPPV Xœì°›NøX/8T“ÐìD~{HEÉ F+D~X+åB8T|<ôF®Þ!ÊXlF®ÞE ¹8T¿žGNÖQA)T"Yώ£Gb±NnB5U a²DèÝmWB5U@*T"(&' I#=:D A# " " TFA!ÖQDZqk%mi#`qcqhFOB!ú NPPV Xa²E¹+EG!2ñDàpXõ'7!2ñD ’EÿP.Ew¹A0T"ëA NPPV X8@7@Q*" ̘E8@8TFE„,!”c8Tymbd e k / YmW/!×iF°›’kBJJa²A)T.I.FG NPPV EÓÙ8T3B/N…§A)T" 0EG5RDTª5/LfA)T"(&' V#=:D " 2!HB C# " rýEÅE#8Tçµ°›mWF&{õ'G!¯ÄF 5!<4?E>8 B3Vš’<ú’EQTçµ°›B¸,RU@*T"¯ œ ì å ­ ì D é Ò E # 7 @ CPAP G conventional Ì3AG!NPPV FrýEÅE#8TaeìE”7@G oxygen therapy BJJauD°›ê®Þ!PaO2! IO2 â F ^R.D[jgqbGÎ5U@*D*/!a²ìXÎÀ ß!©¹6%Fˆ÷!š’<ú’®Þ!ÊXl®ÞXO 8TU¼/Õï5U??)T"NPPV XÖQÓÙ7<É <R8":EMFˆ÷/û˜EANRUT3BGØf óA2€X¢[7@¹,H!NPPV EQS°›™CFˆ A)T"bilevel PAP G CPAP 7dEa²ì/ANRU ÷XûN!°›¾=Pº>ƃ)ù©àXˆ÷7!š’ @*T/!CPAP BJJ@î]b±Fˆ÷Gá^5U@ <ú’X‡K7<S!›@mWX²lQ1¹,TDCF *D*"CPAP B bilevel PAP BAå ·ÃFEàlE j3/˜$A0T"{VArýEÅGœ¦Eür8T3 ÁGD1!L<ane^XÛ*<œìå ·ÃE»R8 B/)S!ú’FdZlq_/*UTBî]F—«XF TœìDéÒE#7@Oa²DÍmVWA)T"œìå +3B.R!ürF-7/)UHts:9š’<ú’‚ ­ìDéÒE#7 NPPV&CPAP -QI bilevel PAP'G AF°›’kEw¹8TLf/)T"(&' II#=:D " š’<ú’EQTçµ°›XauE®Þ5:T"L< C# "¤¬/)UH"=:D B# " CPAP Gî]b±Xˆ÷5:T"œìå­ìDéÒE# 3!E3-6*;%1?A) 7@G NPPV&:E CPAP'X&{õ'B7<°›’ D¨‹±xàE-2Tœì˜ NPPV Fa²ìE”7 kX8J0A)T"(&' I#=:D A# " " @G!ICU DCFœozAFàpê/ÞD*<N! 6!2.C9 *L=¨q/9RU@*D*"TAFD¨‹±xàX ŠÜE-2T NPPV EG*L= RCT EQT^ŒD[ –M¶þ쟍ώ&restrictive thoracic disease : RTD' jgqb/D*"a²ìXÎ8àpU¼G¡BÚ$EÕ FW9.Dœì˜ NPPV àpXLBNTB!ú’-Q ï5U??)T"ŠÜG 1 p4BEvD>@-S!¥à IäÔ1çµ°›X‡KA0TŒlG 50( ö±B.*" p.RØàp!(;ŸOŠÜ.R!EŠÜDC5L6L {V!W/½AG COPD B74.;UtâFn´Dí A)T"NPPV EÖQÓÙ7!.?!ŠÜF’kEO ð/U¼5U@*T"Y]ZioZqAG!NPPV EÓ U@*TÉóAG!àp4BE2€X¢[7@¹,H! Ù7<ÉóE-*@G!NPPV XD¨‹±xàFœì˜ »RàXRE8T3BD1°›™CFˆ÷XûNT3B E#8T°›’kVWF&{õ'B8T3BXèÝ8T /A0!ú’X‡K7@!¤³òÑXû˜E‰È8T3 "(&' IV#=:D A$# " " B/A0T"(&' III#=:D B# " "<=7!gs‘š EF+šŸFEîPæ¹EGÖQE,uXP+J0A)
  5. 5. Noninvasive Positive Pressure Ventilation(NPPV)]ZkuZz 483 T"˜!&ªDU8T NPPV EèœD÷ü6?+C+ +F¨FEuóŸ0 COPD }˜@*Tú&uŒDU8 ê@E*Ú@F!CôJBF3"6q+'978 III(P ' T NPPV EšÐ9F—R/@FC2!<·gD3"8 "K<!Ë°6!/v6!Á|!PaO2!PaCO2! KU C( Tà´0C+'978 IV(PKU C( ' " SpO2 @tlevz_6!J`Í 30'60 ˆfj@ð¥Ð ?^ B"[QECXR ”Wƒ‘6?!—D0nRUC+&ª@*UG!°¯: 1"GSQ@BM> 9Dª¢pH¢D?S¡-TI1@*T" “9©D.3T NPPV F!uÀšÍƒ&P>dÍN 7"OFEC]T/H-.0I<YZ ®&CBEÖP9¶œóŸ(restrictive thoracic disease : 1ÓË°§/RE¡[é‹D NPPV Wœ+T7€D RTD)@F!‡ˆ.QHV0ÜE}›gY«™Cxj >+?!5 >E RCT 0*T0!&ª6FT2C+"K ycp^iYmCbâW¥ME?Eaq&jƲD.+ <“9Šå9uóŸ(COPD)E±9K{ª0õCU' ?!;–›ÍP QOL E—D0Û5U?.S!Þr8 óŸ@*T<N!T2EÀ¬Wm24AFq6+";E @DÔ2œ+RU¦ÒCð¥:=0nRU?+T"’] €”@!COPD &ªDÊ=?F!I©y¢&ªD NPPV ZkuZz@F!hE*T RTD &ªDU6?c© W<·gDms8T4A@!됢!1ÓË°©£!s NPPV Wms8T4AW3"8T'978 IV(PKU ' "4UF VAP ‡©£F—D8T'978 II(PKU B( ' C)( " x;¢0š€DÈ$8T4A/R;7<’t90Ù+" 2"COPD%[QA& „Ž!;U}˜EóŸ@FÞÍEƲD©V5UT'9 “9Šå9uóŸ(COPD)E“9Ë°…EŸôEæ 78 II(PKU C( ' "QSÔ|~@&ª6ET+¨%Å ZË°`XDF!ŒžgCXny&g0‚DCT" k0‚@*TA×-T" NPPV DF!Ë°¸E¯OДPË°bA¾Evdh 8";XR/W*DQECXR iYz_E’t90ñá5U?+T"K<!COPD D Á‰{9óŸ!̽¦DU8Tµ§C¥!K< z,4•ïË°(™0 NPPV @—D8TA+,ÛO Ý5‚-!L§‚-!ciyZkèœÍE˜Š…E!Ÿ *S!ÄÕ¤« QOL E—D!ãs‡EÈ$P±9K{ 8ŽE±9Ë°…EŸôDU8T NPPV EèœF!H E„jEÈ$D>C0TA×-RU?+T"NPPV Em ¢!1ÓË°D‚Ø8T„jWeŽ5:T4ADQS  sD*<=?F!Œžgp“ð¥WØ=<,-@!‚ B&WF7NA8Tډ&Ex;¢WeŽ5:!›ÍE 9W{^8T4A0‘K6+"K<!&ªWº”6!m —DWL?+T(:1$'978 II(PKU A( ' !#î$ s 3'4 Â Í D Á ‰ ] c Å â!4 • ï Ë ° , W# '978 V(PKU C(" ' ) QOL#NPPV EaznuZXzcƒ‘WØ+!¿QE U'ŸôF!Ë°§Ú‰&ERæ0®VU!Ë°ßq ‚9Wƒ‘8T‚0*T'978 II(PKU C)( ' " 0µ2! 3"[QNXR/+,152$:#46$34EC !Ë°60 30'35 –! ˆ})(‚2+Ã@FC+) “9/…EDg[&z#cj&^cË°(Cheyne- "PaO2! IO2 0 300 } Ž K < F PaCO2 0 45 mmHg } F Stokes Respiration : CSR)0ډ8TA!›Í0—R/ ) D{8T"6<0=?!CSR DFR/Eð¥0‚ 9"ARDS! ALI!JLV= A×-RU?1<"CSR Dœ+RU?+Tð¥A6 ±9Ë°³Mw&Ï»(acute respiratory distress syn- ?FÉæ!CPAP!çG°s!CRT(cardiac resynchro- ±9uS!(acute lung injury : ALI) drome : ARDS)! !NPPV D©í6<‹þË°¥CB nization therapy) F!ö%E.øDQ=?†1­45U<u#Á¢l• œ+RU?1<"CPAP D>+?F!ä¹E RCT EÀ 9E­0D­…8Tú&E±9Ë°…E@*T"ARDS! ”@;R¢E—DWñ:C/=<OEE!„ê@@E ALI EË°¢ E¨’Fª¢pH¢ŽEž|1ÓË° RCT @F;R¢E—D0ñ5U!/>¤ô@ QOL E— @ * T 0!„ † E & ª D F NPPV 0 š Ð @!VILI D0ñ5U<4A/R CPAP F3"5UTI1𥏠(ventilator-induced lung injury)P VAP(ventilator- @*T'978 II(PKU B( ' "çG°s¥O 3  associated pneumonia$1ÓË°§¤«uŒ)CBEÚ A+=<]©E}›(€uzfs}›ìÇ)@F“9 ‰&W–~@1T’t90*T'978 IV(PKU C( ' " /…EE QOL Ñ)0ñ5U?.S!çG¥O3"5 ú&uŒ(˜Š…EDډ6<&ªWÿ2)@F!¨F UTð¥@*T'978 III(PKU B( ' "„Ž!‹þË uóŸDQ=? NPPV E3"xow0CT"“9Š °¥!oDb&r8Î| _¼1ÓË°§(adaptive å9uóŸ(COPD)Dډ6<ú&uŒD.+?F! pressure support servo-ventilation : ASV)Wœ+<ð NPPV 0ùað¥òXæ©£W]û6!H¢¢.QHë ¥D>+?FT20¬ýƲÛD£KT4A/R!É ¢WeŽ5:T4A/R!NPPV Eèœ03"5UT ïi@F3"@1C+'978 V(PKU D( ' " '978 II(PKU B( ' "„Ž!“9uóŸ0C+!*T
  6. 6. 484 rË°•î 44$6%!2006" 4!>?:,-72/ p©AG!NPPV Eþ#6@*D*¤µAG![HFv }”c£­*ϼG!Øh}”$BMI'30 kg! % m ! 2 a]/Ø*#*() VI$95; C$ # " ØqåŽXDÅ*$PaCO2'45 mmHg%Vy+! * F 6.6!­¦<šE{J@!NPPV V ž8S5B/! OSAS$AHI'30%©A)R!aΣ+›/ØhA) ­n!w!·ž!2¢dxWEqvdg/)S"'¡! S;M!$¤Áو*Vù®6O82Ì„¦FƒPA ‘4F¢–hO NPPV ^WFÑ,EPR!8УO| )S"ñ¥EG!ʧBlðE!nasal CPAP /S†@ C7/ØKS‘u7/)S"A0S<3 NPPV V ž VA)S#*() I$95; A$ # "6.6!b.F OSAS 6@[HO­¦<šV—~8S;M!NPPV FÂÈ/) ¡÷E{6!Ø{F CPAP /ŸD5B/M2!:F Sƒ¥¬¨B!ºƒ!ICU /ªÀ8S" „˜¢F;Mñ¥FÃK/p6.>;R!CPAP <3A 7!<=1%'& G5–F desaturation VíA0D*-Ù/)R! ±7FzV1??!*.EáUñ¥V`«EÃKA bilevel PAP O auto CPAP EPSñ¥/ŸBDS5B 0S./ NPPV 8ÐFÇA)S"5F;MEG¡÷- N)S#*() IV$95; C$ # " PI’JF¶…/!ŸA)S" 5!80".4+ ¥ÍèV2B6;c#pEPS NPPV õ싌F 3¸ô¡E®ˆ8SÓI7+›/N;Q8“7Ë° »NdD¶…!áUAF¥ êm! Ë°vklve#_t „CG NPPV FÝNP*eŒA)S"“7wc£­ yE,@!Y„ƒ¥´¨!ö•d!Âàdë‹/Ä. */VtM;B0!rFk•Åa‡:A PaCO2 / 45 9D*" mmHg },E,)6;B0!)S*G5–ðE SpO2& áU NPPV FúDgunwG![Wv#]Ooa] 90( / 5 ‡},K2.Crib#ð§F 10( },A) E..USNF/M2!gunwEG NPPV ms TH!›§ NPPV Všç8S"ƒ/!ƒPEŒ7@] ðF¡÷¶…/œE¤?"òB­·GKT</¹±OŒ §EN NPPV Va8S"­n‡|Š/£­VŽ4D VŸ8S" *P+Ee<Dv¬%ZV×7S5B/0UM@!ŸA ±7FzG­n¢?EPSNF/ÝNM2!ɈOâ )S"fs_Zyj½¸`agxmX#$DMD%O¸ VÖ*?? NPPV AOŒA0S5B/M*"6.6€ ‚"7GãՎ*$ALS%AG NPPV VÖ+5BEP ó+›F)S©!€.E‡|†/M*©!åDŽF€. R9˜ÌO QOL G™Q.E™A8S#*() II$9 # Ez*©AGE«1ÿd4ÒË°/Ÿ</!1ÿd4 5; B$ " ÒË°VL.z.E¨8S¡÷-PI’JF€ét 6!63 /:FghŸA)S" (ï«A`« NPPV FeŒBDSô¡OƒPG!3 ±7FzEPQD*k•ÅaFzŽBý’«F@V ¸ô¡!‰Þ½5–ð—Ë°*ϼ!jœ©š¾8 G~3QTD*”TA)S" .!5–F£­_=+›!;^ÌG«!Ú¾8„C*! D-!5FYhuYyG!YhuYyìÖ¦¢~ >fQø.*!­¦ëw¾8Oc¾8!;6L&! ‡•PR!äi¢Ô$³gRŸRŸ‰ƒŸÆ²“Ë°ª cystic fibrosis A)S#*() III$95; B$ # ";<6! o“Ÿ% !¯Š¿æ$0üRŸƒŸ…o“ŸS†×Ü%F eŒô¡F+=!;67¸‚"*$spinal muscular atro- ‚!êmVû3;" phy : SMA%!½DC!¢–h/ 7 ß}F­nŠÛ

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