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9 Cards in this Set
- Front
- Back
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What is the primary goal during OLV?
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maintenance of adequate arterial oxygenation, while providing a surgical field favorable for visualization and manipulation of the operative lung
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The use of higher Vt's during OLV are associated with what?
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-auto-peep
-increases in inflammatory mediators and in alveolar fibrin deposition and other markers of procoagulant effect, which characterize acute lung injury |
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The recommended ventilation strategy for OLV:
Vt = Plateau pressures = |
vt = 6ml/kg
limit plateau press to < 25 permissive hypercapnia is acceptable |
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How do we manage oxygenation during OLV
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air-O2 mixture up to 100% O2;
after stabilizing oxygenation, the FiO2 should be weaned to reduce the effects of absorptive atelectasis |
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________ should be avoided b/c it can cause vasoconstriction in the dependent lung decreasing blood flow
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hypocapnia
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What is the first thing the CRNA should do if hypoxemia occurs during OLV?
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should assess for physiologic causes or tube malpositioning
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What negative effect can excessive peep have on the lungs?
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overdistention of alveoli with exessive peep may increase the areas of ZONE 1 and create more "dead space Ventilation"
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If the use of CPAP and PEEP fail to improve oxygenation during a hypoxic episode during OLV - what else can be done?
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early ligation of the pulmonary artery in "pneumonectomy patients may be used to improve oxygenation"
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What effect does clamping the pulmonary artery have?
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clamping it will immediately stop all significant flow through the lung that is contributing to the shunt.....will increases PaO2
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