ARTP 09

Question 1

What are the two types of resp failure

Answer 1

Hypoxemic resp failure (type 1)

Hypercapnic resp failure (Type 2)

Question 2

What is the primary problem of type 1?

Answer 2

inadequate oxygen

Question 3

What is the primary problem of type 2?

Answer 3

ventilatory failure of the lungs resulting in elevated CO2 levels

Question 4

Initial FiO2 setting

Answer 4

100%

Question 5

PEEP initial setting

Answer 5

Typically starts at +5cmH2O

Question 6

Initial TV settting

Answer 6

6-8mL/kg IBW

Question 7

Alveolar Ventilation formula

Answer 7

(VT-VD) RR = VA

Question 8

Normal/limit values for PF ratio

Answer 8

350-450 <200

Question 9

Normal/limit values for VD/VT

Answer 9

25-40% >60%

Question 10

Normal/limit values for A-a gradient

Answer 10

25-65 >350

Question 11

Normal/limit values for minute ventilation

Answer 11

5-6 >10

Question 12

Which two diseases can handle the unwanted cardio side effects of PPV?

Answer 12

staticus asthmaticus because of increased RAW and ARDS because of decreased lung compliance

Question 13

How does PPV cause barotrauma/pneumo?

Answer 13

Caused from PIP >50cmH20 or PEEP >20cmH2O

Question 14

How does PPV cause fluid retention?

Answer 14

PPV will increase the MIP which will effect the heart, releasing ADH. Leading to pulmonary edema
Prevent by restricting fluids

Question 15

What is the most common Human error ?

Answer 15

Rt main stem intubation

Question 16

Prolonged vent support will result in what?

Answer 16

atrophy of the muscles.

Prevent by minimizing sedatives and switch to a mode that encourages spontaneous breathing

Question 17

Failure to provide adequate vent support will do what?

Answer 17

results in muscle fatigue due to increase of WOB

Question 18

Normal ICP range

Answer 18

5-15

Question 19

How do you treat an increased ICP?

Answer 19

deliberate hyperventilation to keep the PaCO2 between 30-35mmHg***

Question 20

PaCO2 acts as a what naturally in the body?

Answer 20

CO2 will vasodilate

Question 21

Hypovolemia/hypotension is caused by what?

Answer 21

VT over 8ml/kg

Treat by increasing expiratory time/fluid, correct VT range of 6-8ml/kg/vasoconstrictors

Question 22

three clinical goals of CMV***

Answer 22

provide mechanical power to maintain physiologic ventilation
improve ventilation/oxygenation
decrease WOB

Question 23

Assessment of what two things allows you to find out if problem is acute or chronic?

Answer 23

HCO3 and pH

Question 24

In acute, every +10 of PCO2 will do what to the pH?

Answer 24

pH will drop 0.08. Drops 0.03 in chronic

Question 25

4 indications for CMV

Answer 25

Apnea
Acute Vent failure (<7.2/>55 CO2
Impending failure
O2 failure (PaO2 <60mmHg)

Question 26

Impending failure criteria

Answer 26

Multiple ABGs with RR >35 and not slowing, and max minute vent is 10Lpm for a long time

Question 27

4 S/S of O2 toxicity

Answer 27

nausea,cough,irritation of trachea,substernal chest pain

Question 28

Preventing O2 toxicity

Answer 28

FiO2 of 50% or less to achieve PaO2 of 60 or more