6. Ventilatory Support Flashcards

1
Q

Sx of OSA

A

Snoring framed by breathing pauses
Excessive daytime sleepiness ( maybe even during driving)

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2
Q

Ix of OSA

A

Home sleep study- AHI
Only consider polysomnography of unclear or no high AHI index

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3
Q

WHat is needed for Dx of OSA

A
  • 15 apnoeas → desaturation of more than 4%
  • If less than 15 can do polysomnography
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4
Q

What diseases is sleep apnoea assoc with

A
  • Assoc with hear disease/ CV disease
  • cognitive impairment
  • RTA
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5
Q

when is CPAP used and when is BIPAP used

A

CPAP for OSA, BIPAP for acute TIIRF and COPD exacerbations

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6
Q

When can domicillary NIV be given

A
  • if have chronic respiratoru hypercapnoea
    • 2 levels of pressure delivered
    • Designed to reverse TIIRF by increasing ventilation
    • Chronic TIIRF eg.. NM failure, MND etc
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7
Q

Which pts can be given LTOT

A
  • For chronic hypoxaema
  • PaO2 < 7.3, checked x2 3 weeks apart, 6 weeks since exacerbatn
  • Slow progression of pulm HTN, decrease in mortality
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8
Q

When should pneumonia patients be admitted or sent to ICU

A

3 or more

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9
Q

What is target SPo2 for acutely unwell pts ( both scales)

A

94-98% vs 88-92 if risk of chronic hypercapnoea

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10
Q

When should venturi mask be given

A

If target 88-92 or unwell with type I

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11
Q

oxygen range from venturi

A

Fio2 24-60%

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12
Q

Define RF

A
  • PaO2 < 8kPa * breathing air
  • or PaCo2 >6.5 kPa
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13
Q

Possible compensation for hypoxia

A

Mild resp alkalosis due to blowing off Co2

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14
Q

If pt is hypercapnic and Pa02>8, is this RF

A

yes

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15
Q

pH in chronic TIIRF

A

may be normal due to raised bicarb to compensate for resp acidosis

Primary resp acidosis with sec metabolic alkalosis???

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16
Q

Acute on chronic TIIRF tx

A

give venturi and reduce oxygen supplementation so pH comes up. If pH doesn’t come up then give NIV

17
Q

What does +ve and +ve BE mean1

A

High means alkalosis, low means acidosis

18
Q

Compensation for metabolic acidosis

A

Kussmaul breathing, hyperventilation to blow off co2

19
Q

what drugs can cause respiratory depression, CO2 retention and hypoxia

A

BENZOs

20
Q

What does it mean if there are more lung markings centrally than periphally

A

Could be pneumothorax

21
Q

What does reduced lung markings peripherally possibly suggest

A

CF exacerbation

22
Q
A