4 - Ventilator Management

Question 1

What is the purpose of residual volume?

Answer 1

Ensures lungs (alveoli) stay inflated.

“The hardest part to blowing up a balloon is the first part”

Question 2

What is the difference between inhalation and exhalation in regards to active vs passive?

Answer 2

Inhalation - Active

Exhalation - Passive (normal), even with most ventilators

Question 3

How is a high frequency ventilator different than normal units?

Answer 3

Active Inhalation

Active Expiration

Active expiration is a key difference, with most ventilators this is a passive process (like lungs)

Question 4

Objective: What do you manipulate to adjust CO₂ values in a patient?

Answer 4

• VENTILATION (Minute Ventilation)
• MV = Rr x V_T
  
  • MV = Minute Ventilation
  • Rr = Respiratory Rate
  • V_T = Tidal Volume
• We adjust these depending on whether we want CO₂ to increase or decrease

Question 5

Objective: What do you alter if your patient has an issue with O₂?

Answer 5

• OXYGENATION (MAP)
• Adjust Mean Airway Pressure (MAP)
  
  • ​Area under breath curve
  • Can alter PEEP , PIP, iT
  • PEEP is easiest, and most common

Question 6

When adjusting ventilation values, what is a key difference between adults and children wrt volume and pressure?

Answer 6

• Babies: Most often adjust pressure, as volume is already very low
• Adults: Most often adjust volume, as you are working with larger values

Question 7

Objectives: What are the following values on a breath curve?

PEEP

ΔP

PIP

iT

MAP

Answer 7

• PEEP: baseline positive pressure
• ΔP: PIP - PEEP
• PIP: Max inspiratory pressure
• iT: Inspiratory time; how long to get breath in
• MAP: Total area beneath breath curve