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23 Cards in this Set
- Front
- Back
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CMV/AC continuous mech vent assist control |
delivers preset tidal volume or pressure in response to P inspiratory effort initiates breath if P fails to do so |
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Volume-controlled (VC) CMV is used as the primary mode of ventilation in: |
spontaneously breathing patients with weak respiratory muscles. |
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Pressure-controlled (PC) CMV is used in: |
in patients with decreased lung compliance or increased airway resistance, particularly when the patient is at risk for volutrauma. |
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Intermittent mandatory (volume or pressure) ventilation (IMV), also known as synchronous intermittent mandatory ventilation (SIMV): |
delivers gas at preset tidal volume or pressure and rate while allowing patient to breathe spontaneously; ventilator breaths are synchronized to patient's respiratory effort |
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Pressure-regulated volume control ventilation (PRVCV): |
a variation of CMV >combines volume and pressure features; >delivers a preset tidal volume using the lowest possible airway pressure; >***airway pressure will not exceed preset maximum pressure limit |
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PRVCV is used in patients with: |
rapidly changing pulmonary mechanics >(airway resistance and lung compliance), >>>limiting potential complications |
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Intermittent mandatory (volume or pressure) ventilation (IMV), also known as synchronous intermittent mandatory ventilation (SIMV): |
delivers gas at preset tidal volume or pressure and rate while allowing patient to breathe spontaneously; - ventilator breaths are synchronized to patient's respiratory effort |
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Adaptive support ventilation (ASV): |
ventilator automatically adjusts settings to maintain 100 mL/min/kg of minute ventilation; pressure support |
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Constant positive airway pressure (CPAP): |
positive pressure applied during spontaneous breaths; patient controls rate, inspiratory flow, and tidal volume |
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Pressure support ventilation (PSV): |
preset positive pressure used to augment patient's inspiratory efforts; patient controls rate, inspiratory flow, and tidal volume |
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normal RR set |
6-20/min |
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typical tidal volume |
10 - 12 mL/kg |
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tidal volume for P with ALI |
6 - 8 mL/kg |
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FiO2 |
21% - 100% to maintain PaO2 <60 mmHg and SpO2 > 90% |
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typical PEEP |
3 - 5 cm H2O |
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Typical Pressure Support PS positive pressure used to augment patient's insiratory efforts |
5 - 10 cm H2O |
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Inspiratory flow rate and time |
40 - 80 L/min |
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I : E ratio |
1:2 or 1:1.5 |
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Pressure sensitivity |
0.5-1.5 cm H2O below baseline pressure |
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Flow trigger: |
1-3 L/min below baseline flow |
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high pressure limit |
10-20 cm H2O above peak inspiratory pressure |
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RSBI < 105 rapid shallow breathing index |
considered predictive of weaning success |
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Indications of weaning intolerance |
Decrease in LOC• SBP +/- 20 mm Hg• DBP > 100 mm Hg HR + 20 beats/min• PVCs >6/min, couplets, or runs of v- tach Changes in ST segment (usually elevation) RR>30/min or < 10/min or RR + by 10/min Spontaneous Vt < 250 mL• Paco2 increased by 5 to 8 mm Hg and/or pH less than 7.30• Spo2 less than 90%• Use of accessory muscles• dyspnea, fatigue, or pain• Paradoxical chest wall motion or chest abdominal asynchrony• Diaphoresis• Severe anxiety |
