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31 Cards in this Set
- Front
- Back
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What is the priority of critical life functions?
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Ventilation
Oxygenation Circulation Perfusion |
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Define Respiratory failure
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RF is the inability to maintain either normal delivery of O2 to tissues or normal removal of CO2 from the tissues
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What is the blood gas criteria for RF?
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PaO2 < 60 mmHg
PaCO2 >> 50 mmHg |
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What are the 7 causes of hypoxemia?
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V/Q mismatch, shunt, venous admixture, hypoventilation, dcreased FiO2, diffusion defect, perfusion/diffusion defect
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How can you differentiate between shunt and V/Q mismatch
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a V/Q mismatch will respond to oxygen therapy but shunt will not
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How can you tell if a low PaO2 is purely caused by hypoventilation
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with hypoventilation, the A-a gradient will be normal
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How can you increase oxygenation if a patient has a venous admixture problem
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the patient needs more CO or more hemoglobin to increase the PaO2
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How do you differentiate between type I and type II RF?
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Type I RF: pt. can maintain ventilation, but not oxygenation
Type II RF: pt. cannot maintain ventilation, which results in decreased oxygenation |
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What are the three major groups of disorders that are responsible for hypercapnic RF?
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Decreased ventilatory drive
Respiratory muscle fatique/failure Increased WOB |
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what are the five most common factors that lead to acute on chronic failure
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bacterial or viral infection
pulmonary embolus CHF chest wall dysfunction medical noncompliance |
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What is the goal of mechanical ventilation
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to support the patient until the underlying problem is resolved
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what is the critical value for PaCO2
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PaCO2 > 55mmHg
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what is the critical value for
pH |
pH < 7.20
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what is the critical value for
VC (ml/kg) |
VC 10 ml/kg
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what is the critical value for
MIP |
MIP less than or equal to
-20 mmHg |
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what is the critical value for
MVV |
< 2 x VE
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what is the critical value for
VE |
VE > 10 L/min
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what is the critical value for
VD/VT |
VD/VT > 60%
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what is the critical value for
P(A-a)O2 on 100% |
P(A-a)O2 on 100% >350
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what is the critical value for
P/F ratio? |
P/F ratio < 200
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what P/F ratio is considered an indicator of profoundly impaired oxygenation
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P/F < 200
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Define MIP and five minimal value for most patients
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maximum insp. P generated in 20 sec. of breathing against a closed glottis;
Normal > 60 cmH2O -20 pt. will have difficulty maintaining spontaneous vent |
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what are 3 conditions that can lead to respiratory muscle fatique
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COPD
kyphoscoliosis obesity |
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Define noninvasive ventilation
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Application of positive pressure with out an artificial airway
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How does NPPV help cardiogenic pulmonary edema (CHF w/pulmonary edema)
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NPPV can reduce both the preload and afterload on the overworked heart
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How does hyperventilation result in lower ICP in head injury
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decreased levels of CO2 constrict the blood vessels in the brain which decreases blood flow
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What are the general tidal volumes and flow rates used for patients with COPD when using NPPV
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(when using NPPV)
tidal volumes of 6-8 ml/kg Flow rate >60 (70-100 L/min) along with a short Ti |
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Hypoxemic RF is usually due to what 3 conditions
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V/Q mismatch
Shunt hypoventilation |
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Hypercapnic RF is usually due to what 3 conditions
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inadequate drive
respiratory muscle fatique excessive WOB |
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the goal of therapy in acute hypercapnic respiratory failure is:
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guarantee a set minute ventilation
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what is the normal P(A-a)O2 gradient
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Normal P(A-a)O2 gradient is 5-15 mmHg;
at age 20 normal is 5 & it is increased by 4 mmHg per decade |
