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27 Cards in this Set

  • Front
  • Back

On what conditions is oxygen therapy effective?

VQ mismatch, diffusion defects, and hypoventilation.

What parameters should be periodically evaluated in patients with COPD who are receiving oxygen therapy?

PaCO2

What levels of FIO2 have been considered safe for preventing significant long impairment?

0.50 or less for 2 to 7 days

What is true of ROP?

A higher than normal Pa02 may cause our ROP.


The Pa02 is the critical factor in ROP, not the FIO2 per se.


ROP may cause permanent blindness.

What are characteristics of Ali?

Alveolar capillary membrane injury, widespread atelectasis, and low compliance

What substances are examples of inflammatory mediators?

Cytokines, Endotoxins, and Prostagladins

When should CPAP or PEEP be considered?

If a Pa02 of at least 60 mmhg with an FIO2 of 0.5 or less cannot be achieved.

What are considered poor candidates for PEEP and CPAP?

Unilateral or localized lung disease, Normally compliant lungs, and highly compliant lungs

What is an absolute contraindication for cpap?

Patients who cannot sustain adequate spontaneous ventilation

In what type of patient is plateau pressure not a reliable surrogate for assessing alveolar overdistension?

Patients with restricted chest wall and diaphragmatic movement

What are considered mechanisms of ventilator induced lung injury?

Barotrauma, Volutrauma, Biotrama, and Atelectrauma

What levels of title volume are associated with a 22% reduction in mortality of patients with ards?

6mL/kg

What strategies are considered the standard of care in preventing alveolar collapse?

Open lung approach

What strategies have been promoted for the management of patients with ards?

Inverse ratio ventilation, liquid ventilation, and high-frequency oscillatory ventilation

By what mechanism does peep or cpap 1. improve lung compliance and 2. reduce shunting and improve arterial PO2?

They prevent collapse in the alveoli and help to reopen alveolar collapse to restore FRC. Reopening increases PA02 and reduces pulmonary shunting.

Stiff non-compliant lungs of the severely diseased patient may not inflate to normal tidal volumes if we limit alveolar pressure to what we believe is a safe level.


A. What may be the undersired consequences of this kind of ventilation strategy?


B. Under what circumstances may it be justifiable to use such venilation strategy even though these negative consequences may occur?


C. What is the term commonly used to describe this ventilation strategy?

A. Hypercapnia and Acidosis


B. Ards and over-distended lungs


C. Permissive hypercapnia


What is the level of PAO2 set as a goal for oxygen therapy in the healthy adult?

At least 60MMHG

What type of oxygen device should be recommended for a patient with hypercapnic COPD?

High flow

Which parameters should be periodically evaluated in patients with COPD who are receiving oxygen therapy?

PaCO2 analysis

What is the minimum level of FIO2 that, when used for a prolonged period of time, has been associated with damage to alveolar cells?

FIO2 above 50%

What is the most common target level of hemoglobin saturation when oxygen is administered?

At least 90%

What is the most commonly recommended position for a patient in the immediate post surgical period to improve PaO2?

Upright positions

How should patients with unilateral lung disease be positioned to optimize oxygenation?

On their side with healthy lung down

What is the major difference between peep and cpap?

Airway pressure does not rise during inspiration with cpap

What is the best correlate of alveolar pressure in mechanically ventilated patients?

Plateau pressure

What is the best explanation for the increased incidence of MODS in mechanically ventilated patients with ards?

Inflammatory mediators cause injury to other organs

What is the generally accepted plateau pressure be low which lung injury is minimized?

30 cm H20 or less