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20 Cards in this Set
- Front
- Back
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What is the purpose of Airway Pressure Monitoring?
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*Enhance safety of ventilation
*Achieve effective gas exchanges *Appreciate the mechanics of the respiratory system (elasticity and vicosity of flow) |
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Common Problems with airway pressure monitoring...
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Leaks in the circuit or mask.
Improper ventilator settings. Disconnections Inadequate pressures and ventilation |
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Spirometry Parameters
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TIDAL VOLUME
---> Volume of air inhaled and exhaled in a normal breath. MINUTE VOLUME ---> TV * RR MAXIMUM AIRWAY PRESSURES ----> Alarm will sound when too high ---> Alarm usually set at 40 cm H2O MEAN INSPIRATORY PRESSURES ---> Alarm will sound when these are too high. Check your alarm each day. PEEP ---> Positive End Expiratory Pressures I:E RATIO ---> AIRWAY RESISTANCE COMPLIANCE |
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Peak Inspiratory Pressure
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Maximum pressure obtained during the inspiratory breathing cycle.
Maximum inspiratory pressure 5 - 40 cm H2O |
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A PIP of what value should raise concern about what is going on?
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30 cm H2O
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What can cause a Low Peak Inspiratory Pressure (PIP)?
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* Very compliant breathing circuit
*Extremely compliant lungs * Significant leak in the breathing system (low pressure alarm should go off) * Low inspired tidal volume * Low flow rate of fresh gas flow |
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What should you do if your pt has a PIP of 30 or higher?
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Look at ventilator settings and pt's position, are you giving them too high tidal volumes for the position they are in?
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What determines PIP?
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Lung Compliance
Breathing Circuit Compliance Airway Resistance Ventilator Settings Patient Position |
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What do you do if low pressure alarm goes off?
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Could be a leak in the system. Track the circuit all the way from the patient back to the machine looking for the leak.
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What can cause a high PIP?
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* Non-compliant respiratory system (COPD, asthma, trendeleburg and lithotomy positions).
* Increased resistance in the breathing circuit (kinks) * Increased resistance in the airway * Inspiratory gas flow is high (8-10 L O2) |
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What can cause a low peak plateau level?
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Very compliant lungs. The tidal volume does not fill them completely. (lower pressures).
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What can cause a high peak plateau pressure?
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Overfilled lungs (Vt too HIGH).
Stiff non-compliant lungs. |
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Compliance
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Measure of how well the lung-thoracic system can change it total volume as a certain pressure is applied.
This is dominated by alveolar properties. |
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With pressure control ventilation, what determines the tidal volume of a breath at a set pressure?
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Lung Compliance.
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Pneumoperitoneum can affect...
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lung compliance.
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Typical compliance for adults is
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35-100 mL/cm H2O
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Typical compliance for a child is
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> 15 mL/ cm H2O
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Resistance
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The force that opposes or retards flow.
Relationship between the pressure difference across the airway and the rate at which gas is flowing through the airway. |
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Diseases with increased airway resistance
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(Anything that closes small airways.)
Asthma Bronchspasm COPD Emphysema |
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Peak Plateau (Inspiratory)
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The pressure obtained at the end of inspiration.
There is a pause at the end of inspiration that is zero airflow. This allows increased alveolar gas distribution. |
