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50 Cards in this Set
- Front
- Back
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CO2 is evaluated by:
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dead space
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benefits of an inspiratory pause:
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it provides increased MAP & increased gas exchange
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while using PPSV
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how should you adjust the vent to address decreased cardiac output?
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transpulmonary pressure (Ptp or Pl) is the difference between:
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alveoler pressure (Palv) & pleural pressure (Ppl)
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transthoracic pressure (Pw or Ptt) is the difference between:
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pleural pressure (Ppleural) & body surface pressure (Pbs)
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transairway pressure (Pta) is the differnce between:
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airway pressure (Pawo) & alveolar pressure (Palv)
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transdiaphramatic pressure (Pdi) is the difference between:
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abdominal pressure (Pab) & pleural pressure (Ppl)
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transrespiratory pressure (Ptr) is the difference between:
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alveolar pressure (Palv) & Body surface pressure (Pbs)
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The equation of motion is:
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P x (Vt x El) + (Flow x Raw)
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The normal Vt for ARDS is:
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4 to 6 ml/ kg
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A normal spontaneous Vt is about:
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5 to 7 ml/kg
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The currently accepted Vt for mech vent in acute resp failure for a patient with ARDS is:
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4 to 8 ml/kg
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The currently accepted Vt for mech vent in acute resp failure for a patient with COPD is:
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6 to 10ml/kg
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plateau pressure should be maintained at levels less than___to avoid alveolar damage from overdistension
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30 cm H20
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when flow is delivered by square wave form
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the dif between Plateau pressure and peak pressure is:
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Cstatic equals:
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Vt/ (Pplat - PEEP)
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the damage that elevated Plateau pressure causes is:
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alveolar air leakage from trauma
release of inflammatory mediators multisystem organ failure |
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With regards to MAP
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prolonging the Te can:
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with regards to MAP
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SIMV & CMV have:
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the effect of PEEP on MAP is simple for:
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every 1 cm H2O of PEEP added
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Intrinsic PEEP (aka Auto-PEEP) equals:
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Total PEEP - Extrinsic PEEP
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The compliance of a 'normal' lung is __ and it's resistance is ___.
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0.1 L/cm H20 ; 1 cm H2O/L/sec
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The initial settings for the recruitment maneuver are:
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PEEP: 20 to 30 cm h2o
Peak Inspire Pressure: 40 to 50 cm H2o Ti: 1 to 2 sec RR: 15/ min Time: For about 1 to 3 minutes |
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The features of a vent that have an effect on W.O.B. are ___
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___
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Describe the physiologic effect of PEEP
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It's the application of (+) pressure to change the baseline pressure during mechanical ventilation to improves oxygenation
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detrimental effects of PEEP include:
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decreased cardiac output
increased pulmonary vascular resistance increased dead space |
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Regarding flow patterns
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a decelerating or ramp:
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The volume control modes in mechanical ventilation are ___ and ___.
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VC-CMV ; VC-SIMV
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In pressure-triggered VC-CMV
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the optimal pressure sensitivity is ___
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The pressure control modes in mechanical ventilation are ___
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___
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In pressure control
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what initiates the breath and cycles the breath?
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Define permissive hypercapnia
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A part of the lung protection strategy
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the most common causes of ventilatory failure are
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post-op resp failure
sepsis heart failure pneumonia trauma ARDS aspiration |
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the goals of mechanical ventilatory support are
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restore acid-base balance
reduce work of breathing maintain alveolar ventilation maintain O2 delivery |
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in lung protective strategies
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how is it possible to keep lung pressures below 30 cm H2O
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the primary indications for mechanical ventilation are
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apnea
acute ventilatory failure impending ventilatory failure severe oxygenation problems |
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the clinical objectives of ventilatory support are
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reverse hypoxemia
reverse acute resp acidosis reverse ventilatory muscle dyfunction reverse/prevent atelectasis relieve resp distress reduce ICP improve cardiac output decrease O2 comsumption |
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the hazards of mechanical ventilation are
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decreased venous return
ventilator induced lung injury decreased cardiac output increased work of breathing increased resp muscle dysfunction due to inappropriate vent settings |
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What's needed to complete a proper order for mechanical ventilation
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mode
FiO2 tidal volume (volume control) pressure level (pressure control) rate peak flow flow wave form Inspiratory time PEEP level trigger sensitivity pressure limits alarms backup ventilation humidification |
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Why would one consider noninvasive positive pressure ventilation (NPPV)?
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NPPV uses masks for administration and can be used as an alternative to traditional 'invasive' positive pressure ventilation administered ETT or a tracheostomy tube.
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the advantages of negative pressure ventilation are
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lack of need for artificial airway
relatively simple easy use of device |
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the disadvantages of negative pressure ventilation are
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difficulty gaining patient access
difficulty moving bulky devices control mode only old devices leaks cause difficulty in maintaining ventilation |
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________ can potentially happened to patient on SIMV that receives sedation
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hypoventilation
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The formula for minute ventilation is ___ and the norm is ____
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f x Vt ; 80 - 100ml/kg/min IBW
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The initial Vt on a vent should be set at ____ and the initial rate should be ____ .
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8 to 10 ml/kg IBW ; 12 - 16 bpm
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When a patient has compliance and/ or resistance changes
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what mode is most suitable?
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what disease states can cause 'auto-peep'?
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COPD
Emphysema Diseases that cause hyperinflation |
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With what types of patients would you give volume-control to?
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Generally
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With what types of patients would you use pressure-control to?
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ALI/ARDS patients
Patients with poor results on volume control |
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the signs & symptoms of acute ventilatory failure are
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tachypnea
dyspnea tachycardia hypertension vasodilatation headache drowsiness sweating redness of skin |
