Advanced Ventilator Modes Flashcards
regular ventilator mode
all mechanical breaths
are advanced ventilator modes mechanical or spontaneous breaths?
both
assisted ventilator breaths happen at what point during the spontaneous breath?
beginning
stacked ventilator breath
when the vent gives a breath in the middle of a spontaneous breath or during expiration
why are stacked breaths bad?
may lead to coughing/bucking and overinflated lungs/barotrauma
assist control ventilation
senses spontaneous breaths and assists them
there is a minimum breaths per min limit and will give a mechanical breath to reach it
if the patients respiratory rate is faster than the set minimum then 2
all breaths will be spontaneous
all spontaneous breaths will be assisted
if the patients respiratory rate is slower than the set minimum then 2
vent will kick in and give mechanical breath
breaths that are spontaneous will be assisted
intermittent mandatory ventilation
set minimum mechanical breaths per min
pt allowed to spontaneously ventilate between
ventilator does not sense pts breaths (could cause stacked breath)
which ventilator mode is the same as when we turn on the vent after intubation?
intermittent mandatory ventilation
synchronized intermittent mandatory ventilation SIMV
set minimum number of mechanical breaths
can spontaneously ventilate between mechanical breaths
CAN sense spontaneous breath
what does the ventilator do in SIMV mode when it does sense a spontaneous breath that would occur during a ventilator breath?
assist the breath instead of stack the breath
2 differences between SIMV and assist control
SIMV has set number of mechanical breath vs assist control has set number of total breaths per min
SIMV does not assist all spontaneous breaths, assist control does.
pressure support ventilation
no mechanical breaths
every breath is assisted
which ventilator mode does the pt need to be spontaneously breathing
pressure support
benefits of pressure support ventilation
1 helps overcome resistance of circuit/decreases work
2 larger tidal volumes/less atelectsis
3 makes spon vent less contraindicted for certain pts
2 things to remember about assist control and SIMV
these are considered vent mode and APL/bag are not in circuit
the pt can still breathe spontaneously even though vent is on
mandatory minute ventilation
pt breaths spontaneously and all are assisted
choose a minumum min ventilation and if you arent acheiving it then it will deliver mechanical breath
BiPAP
similar to CPAP bc continuous positive pressure but the pressure is higher during inspiration than expiration
can BiPAP be done with a face mask or ETT tube?
both
inverse ratio ventialtion IRV
the vent setting actually reverses the inspiratory and expiratory times
IE ratio
advantage to inverse ratio ventilation
longer inspiratory time increases FRC
disadvantages to inverse ratio ventilation
possibility of incomplete exhalation
does not allow spontaneous breathing
high frequency positive pressure ventilation
small tidal volumes
60-120 breaths/min
high frequency jet ventilation
small cannula in airway
120-600 breaths/min
high frequency oscillation
600-3000 breaths/min
airway pressure release ventilation
simular to BiPAP it delivers constant CPAP but will intermittently stop to allow complete exhalation
active scavenging
hooked up to hospital suctioning system
passive scavenging
not hooked up to hospital system
just go into the room
TIVA should be used
max limit of volatile agent in OR when used alone
2 ppm
max limit of volatile agent in OR when used with 25ppm nitrous oxide
0.5 ppm
max limit of nitrous oxide in OR
25ppm
