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Sp: Methods 1 > 10. Adv Ventilator Modes > Flashcards

10. Adv Ventilator Modes Flashcards

1
Q

assisted breath

A

vent gives breath at BEGINNING of spontaneous breath

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2
Q

assisted breath: pro

A

help pt achieve larger tidal volume

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3
Q

stacked breath

A

vent gives breath:
in MIDDLE of spontaneous breath
or
during EXPIRATION

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4
Q

stacked breaths cause

A

coughing/bucking
overinflated lungs
barotrauma

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5
Q

spontaneously ventilating patients will better tolerate ________ breaths

A

assisted breaths

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6
Q

assist control

A

every spontaneous breath is assisted
ensures minimum respiratory rate is met

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7
Q

during assist control, the AA sets _____

A

minimum respiratory rate

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8
Q

SIMV is similar to

A

volume control
pressure control

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9
Q

is the vent sensing patient breaths in IMV?

A

no

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10
Q

IMV

A

ventilator will deliver a certain number of mechanical breaths per minute, regardless of the pt’s spontaneous rate

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11
Q

SIMV

A

set # of minimum mechanical breaths per second
vent senses spontaneous breaths

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12
Q

SIMV vs IMV

A

SIMV senses breath
IMV does not sense breath

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13
Q

are all breaths assisted in SIMV?

A

no - only the ones that occur at the same time as the mechanical breath

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14
Q

pressure support

A

every single spontaneous breath is assisted

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15
Q

PSV benefits

A

decr work of breathing
larger tidal volumes
decr atelectasis
lowers CI for SV in certain pts

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16
Q

what can you adjust in PSV

A

trigger sensitivity
amount of (+) pressure
min resp rate
PEEP
slope
inspiratory term

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17
Q

trigger sensitivity too low

A

vent wont sense spontaneous breaths

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18
Q

trigger sensitivity too high

A

vent might sense cardiogenic oscillations and may deliver breaths when pt isnt breathing

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19
Q

potential problem with high ventilator sensitivity

A

can make you think the pt is breathing faster than they really areno

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20
Q

normal inspiratory flow

A

15L/min

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21
Q

what will trigger pressure supported breaths

A

small respiratory efforts with low tidal volumes

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22
Q

increase PSV sensitivity

A

decrease trigger L/min
(lower flow)

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23
Q

decrease PSV sensitivity

A

increase trigger L/min (higher flow)

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24
Q

situation to INCR trigger sensitivity (DECR flow)

A

pt recovering from NMB and vent is not picking up spontaneous respirations

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25
Q

situation to DECR trigger sensitivity (INCR flow)

A

with cardiogenic oscillations during low respiratory rates

26
Q

inspiratory term percentage

A

how long the vent will support each breath

27
Q

25% inspiratory term

A

pressure supported breath will be terminated once the inspiratory flow rate decreases to 2.5L/min

28
Q

75% inspiratory term

A

pressure supported breath will be terminated once the inspiratory flow decreases to 7.5L/min

29
Q

incr inspiratory term %

A

decr duration of assistance

30
Q

decr inspiratory term %

A

incr duration of assistance

31
Q

decr inspiratory term % allows for

A

a larger tidal volume without increasing positive pressure delivered

32
Q

pt that may benefit from decr inspiratory term %

A

obese pt on LMA

33
Q

mandatory minute ventilation (MMV)

A

minimum minute ventilation
- mechanical breaths delivered if pt is not meeting minimum MV
- spontaneous breaths are assited

34
Q

during BiPAP, is the positive pressure higher during inspiration or expiration?

A

positive pressure is higher during inspiration in order to open the alveoli

35
Q

BiPAP indicaation

A

atelectasis
OSA

36
Q

BiPAP advantages over CPAP (2)

A

easier exhalation
reduces air trapping

37
Q

difference between BiPAP and airway pressure release ventilation

A

airway pressure release ventilation intermittently stops to allow for complete exhalation

38
Q

what 2 vent modes provide constant CPAP?

A

BiPAP
airway pressure release vent

39
Q

inverse ratio ventilation (IRV)

A

vent reverses the inspiratory and expiratory times
(I>E)

40
Q

IRV advantage

A

longer inspiratory time
incr FRC

41
Q

IRV disadvantage

A

incomplete exhalation
- auto-PEEP
does not allow spontaneous breathing

42
Q

High-Frequency Positive Pressure Ventilation (HFPPV)

A

small tidal volumes
60-120 breaths/min

43
Q

High-Frequency Jet ventilation

A

small airway cannula
120-600 breaths/min

44
Q

High-Frequency Oscillation

A

600-3000 breaths/min

45
Q

autoflow ventilation is an adjunct to _______

A

volume controlled ventilation modes

46
Q

autoflow advantages

A

-delivers set tidal volume at lowest possible PiP
-decr peak airway pressures
-pt can breath spontaneous at any time

47
Q

autoflow uses ______ flow to decrease peak airway pressures

A

decelerating flow

48
Q

the vent is more or less likely to breath against the pts expiration during autoflow?

A

less likely

49
Q

volume control inspiratory FLOW waveform

A

square

50
Q

volume control inspiratory PRESSURE waveform

A

peak pressures + plateau pressure

51
Q

autoflow inspiratory FLOW waveform

A

decelerating

52
Q

autoflow inspiratory PRESSURE waveform

A

square

53
Q

active scavenging

A

hooked up to hospital suctioning system

54
Q

active scavenging disadvantage

A

vacuum system requires $$$ pipework
needle valve requires adjustment

55
Q

passive scavenging advantages

A

inexpensive
simple

56
Q

passive scavenging disadvantages

A

impractical in some facilities

57
Q

passive scavenging waste gases can be ducted out of

A

open window
pipe to outside wall
extractor fan vented to exterior

58
Q

active scavenging should be set to

A

10-15 L/min

59
Q

charcoal canister advantages

A

no setup cost
mobile

60
Q

charcoal canister disadvantage

A

continuing replacement cost
does not remove N2O

Sp: Methods 1 (15 decks)

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