呼吸机运行可靠性现状分析及应对措施
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摘要
目的:提高呼吸机的运行可靠性,保障患者的生命安全和临床诊治水平。方法:分析呼吸机使用过程中影响其运行可靠性的重要因素,如关键配件故障、参数漂移、人为原因对运行可靠性的影响。结果:根据对呼吸机可靠性影响因素的分析,从设备配件的升级更换、使用过程中的质量控制及加强人员培训等方面提出提高了呼吸机运行可靠性的应对措施。结论:通过对设备状态的维护、基于设备运行时间的周期性维护、隐性故障的定期巡查以及有效的故障排除措施等方面提高了呼吸机的运行可靠性。
Objective To improve the operational reliability of the mechanical ventilator to facilitate clinical diagnosis and treatment. Methods The factors were analyzed affecting the operational reliability of the mechanical ventilator, including the failure of key parts, parameter drift and human factors. Results Some measures were put forward including the replacement of spare parts, quality control during operation and personnel training and etc. Conclusion The operational reliability of the mechanical ventilator is enhanced greatly by maintenance of the ventilator, periodical maintenance based on running time,regular inspection of hidden failures and so on.
Objective To improve the operational reliability of the mechanical ventilator to facilitate clinical diagnosis and treatment. Methods The factors were analyzed affecting the operational reliability of the mechanical ventilator, including the failure of key parts, parameter drift and human factors. Results Some measures were put forward including the replacement of spare parts, quality control during operation and personnel training and etc. Conclusion The operational reliability of the mechanical ventilator is enhanced greatly by maintenance of the ventilator, periodical maintenance based on running time,regular inspection of hidden failures and so on.
引文
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[23]郑蕴欣,李斌.呼吸机管理中心设备故障分析及对策[J].中国医疗器械杂志,2003,27(6):450-452.
[24]范开洲,谢文,张强.呼吸机临床应用中不良事件分析及质量控制[J].中国医疗设备,2009,24(5):77-78.
[25]吴萌.降低我院呼吸机故障率的研究[J].中国医疗设备,2017,32(7):94-96.
[26]王国庆.关于呼吸机质量控制的探讨[J].医疗装备,2014,27(7):23-25.
[27]COCOROS N M,KLOMPAS M. Ventilator-associated events and their prevention[J]. Infect Dis Clin North Am,2016,30(4):887-908.
[28]WALSH B K,SMALLWOOD C D,RETTIG J S,et al. Categorization in mechanically ventilated pediatric subjects:a proposed method to improve quality[J]. Respir Care,2016,61(9):1 168-1 178.
[29]LEIPLJ A,IWASAKI S,MILNER A,et al. Accuracy of the volume and pressure displays of high frequency oscillators[J]. Arch Dis Child Fetal Neonatal Ed,2004,89(2):174-176.
[2]LEWIS S C,LING L L,MURPHY M V,et al. Risk factors for ventilator-associated events:a case-control multivariable analysis[J]. Crit Care Med,2014,42(8):1 839-1 848.
[3]医疗器械风险管理对医疗器械的应用:YY/T 0316—2008/ISO 14971:2007[S].
[4]CHATBURN R L,EL-KHATIB M,MIRELES E. A taxonomy for mechanical ventilation:10 fundamental maxims[J]. Respir Care,2014,59(11):1 747-1 763.
[5]BROADUS V. Murray and Nadel’s textbook of respiratory medicine[M]. 6th ed. New York:Elsevier,2016:1 761-1 777.
[6]LUJAN M,SOGO A,GRIMAU C,et al. Influence of dynamic leaks in volume-targeted pressure support noninvasive ventilation:a bench study[J]. Respir Care,2015,60(2):191-200.
[7]ALAM M,JONES G,KAHL W,et al. Modeling the weaning of intensive care unit patients from mechanical ventilation:a review[J]. Crit Rev Biomed Eng,2014,42(2):25-61.
[8]邓映雪,凌文嘉. SERVO-i呼吸机故障维修两例[J].中国医学装备,2017,14(9):179-181.
[9]薛文成,崔亮.拉斐尔呼吸机疑难故障维修实例[J].医疗卫生装备,2017,38(7):161-163.
[10]陈俊. PB840呼吸机结构原理及故障分析[J].企业科技与发展,2017(6):98-100.
[11]陈学斌,刘利荣.三种呼吸机气动系统的比较与分析[J].中国医学装备,2014,11(2):33-35,36.
[12]陈学斌.拉斐尔XTC呼吸机常见故障及解决方法[J].中国医学装备,2014,11(12):156-157.
[13]HEULITT M J,THURMAN T L,HOIT S J,et al. Reliability of displayed tidal volume in infants and children during dualcontrolled ventilation[J]. Pediatr Crit Care Med,2009,10(6):661-667.
[14]GOVONI L,DELLACA'R L,PEUELAS O,et al. Actual performance of mechanical ventilators in ICU:a multicentric quality control study[J]. Medical Devices,2012,5:111-119.
[15]许敏光,闫伟,赵红,等.呼吸机的质量控制及分析[J].中国医学装备,2013,10(7):24-25.
[16]李雪源,武振虎,卢娟.呼吸机质控检测发现的问题及解决方法[J].医疗卫生装备,2014,35(7):116-118.
[17]鲁永杰,金伟.呼吸机质量控制及注意事项[J].医疗卫生装备,2011,32(3):103-104,112.
[18]张红远,曲海燕,张祖进,等.呼吸机质量安全风险管理及质控检测结果分析[J].医疗卫生装备,2014,35(8):96-98.
[19]ECRI Institute. Top 10 Health Technology Hazards for 2016[R/OL].[2018-09-23]. http://www.healthcarbusinesstech.com/health-technology-hazards.
[20]KOWALCZYK L. Alarm fatigue linked to patient death[N].The Boston Globe,2010-04-03(1).
[21]CRISCITELLI T. Alarm management:promoting safety and establishing guidelines[J]. Aorn J,2016,103(5):518-521.
[22]蒋友好,彭文,马力.呼吸机的使用现状分析及风险安全管理措施[J].中国医疗设备,2012,27(2):71-73.
[23]郑蕴欣,李斌.呼吸机管理中心设备故障分析及对策[J].中国医疗器械杂志,2003,27(6):450-452.
[24]范开洲,谢文,张强.呼吸机临床应用中不良事件分析及质量控制[J].中国医疗设备,2009,24(5):77-78.
[25]吴萌.降低我院呼吸机故障率的研究[J].中国医疗设备,2017,32(7):94-96.
[26]王国庆.关于呼吸机质量控制的探讨[J].医疗装备,2014,27(7):23-25.
[27]COCOROS N M,KLOMPAS M. Ventilator-associated events and their prevention[J]. Infect Dis Clin North Am,2016,30(4):887-908.
[28]WALSH B K,SMALLWOOD C D,RETTIG J S,et al. Categorization in mechanically ventilated pediatric subjects:a proposed method to improve quality[J]. Respir Care,2016,61(9):1 168-1 178.
[29]LEIPLJ A,IWASAKI S,MILNER A,et al. Accuracy of the volume and pressure displays of high frequency oscillators[J]. Arch Dis Child Fetal Neonatal Ed,2004,89(2):174-176.