Anesthesia Week 2 Ventilator-Diana

Question 1

Flow

Answer 1

Volume/Time

DELIVERY OF VENTILATION IS CONTROLLED BY FLOW

Question 2

Resistance

Answer 2

Change in pressure/Flow

total driving pressure=gradient between the outside and inside pressure EX. inspiratory pressure and alveolar pressure

Question 3

Total sum resistance

Answer 3

patient circuit, tubes conencting to the patient to the ventilator, to the bronchi, chest wall, the lung parenchyma, the distended abdomen

Question 4

Volume

Answer 4

FlowXTime

Flow rate is fixed and where the volume control is done by adjusting the time

Question 5

Pressure

Answer 5

FlowXResistance

Question 6

Alpha angle in ETCO2

Answer 6

Increased alpha angle signifies an expiratory airflow obstruction such as COPD, bronchospasm, or a kinked entotracheal tube

Question 7

Beta angle in ETCO2

Answer 7

Fresh gas does not contain carbon dioxide, so when a patient inspires, the capnograph should immediately return to zero. Causes: absorbent exhaustion.

Question 8

What are the methods of CO2 analysis?

Answer 8

Mainstream attached to the ETT and Sidestream located outside the airway and it requires a water trap

Question 9

Low ETCO2

Answer 9

Hyperventilation: light anesthesia, metabolic acidosis
Decreased CO2 production: hypothermia
Increased alveolar dead space: hypotension, pulmonary embolism

Question 10

Elevated ETCO2

Answer 10

Increased CO2 production: MH, sepsis, fever, hyperthyroidism

Decreased alveolar ventilation: hypoventilation, narcotis

Question 11

Rebreathing

Answer 11

Causes are exhausted CO2 absorbent, incompetent expiratory valve, hole in the inner tube of a Bain system, inadequate FGF with Mapleson circuit.

Question 12

Causes of increased ETCO2

Increased CO2 production and delivery to the lungs

Answer 12

Increased BMR, malignant hyperthermia, thyrotoxicosis, fever, sepsis, seizures, laparoscopy, tourniquete or vascular clamp removal, sodium bicarbonate administration, pain, shivering, anxiety, increased muscle tone, medication side effect

Question 13

Causes of decreased end tidal CO2

Decreased CO2 producrtion and delivery to the lungs

Answer 13

Decreased BMR, increased anesthetic depth, hypothermia, decreased pulmonary blood flow, decreased cardiac output, hypotension, pulmonary embolus, V/Q mistmatch, medication side effect

Question 14

Increased End Tidal CO2

Decreased alveolar ventilation

Answer 14

Hypoventilation, CNS depression, residual neuromuscular blockade, COPD, high spinal anesthesia, neuromuscular disease, metabolic alkalosis, medication side effect

Question 15

Decreased End Tidal CO2-

Increased Alveolar Ventilation

Answer 15

Hyperventilation, inadequate anesthesia, metabolic acidosis, medication side effect

Question 16

Increased End Tidal CO2

Equipment malfunction

Answer 16

Rebreathing, CO2 absorbent exhaustion, unidirectional valve malfunction, leak in breathing circuit, increased apparatus dead space

Question 17

Decreased End Tidal CO2

Equipment Malfunction

Answer 17

Ventilator disconnect, esophageal intubation, poor seal with ETT or LMA, sample line leak, airway obstruction, apnea

Question 18

SPO2 calculation

Answer 18

SpO2 90%= PaO2 60 mmHg
SpO2 80%=PaO2 50 mmHg
SpO2 70%=PaO2 40 mmHg

Question 19

Left shift= Increased affinity

Answer 19

Decreased Temperature
Decreased 2,3 DPG
Decreased CO2
Decreased H+
Increased PH
HgbMet
HgbCO
Hgb fetal

Question 20

Right shift=decreased affinity

Answer 20

Increased temperature
Increased 2, 3 DPG
Increased CO2
Increased H+
Decreased PH