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Principles I summer 2024 > capnography > Flashcards

capnography Flashcards

1
Q

what are the 4 effects of hypercarbia

A

respiratory acidosis
increased CBF (inc ICP)
increase pulmonary vascular resistance
potassium shifts from intracellular to intravascular

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2
Q

5 effects of hypocarbia

A

respiratory alkalosis
decreased CBF
decrease pulmonary vascular resistance
potassium shifts to the intracellular space
blunts normal urge to breath

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3
Q

besides providing information on ventilation capnography can also provide information on

A

pulmonary blood flow
aerobic metabolism
placement of tube
integrity of breathing circuit
estimates the adequacy of cardiac output

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4
Q

what does the bohr equation calculate

A

physiological dead space

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5
Q

what is dead space

A

volume of each breath inhaled that does not participate in gas exchange

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6
Q

what is anatomic dead space

A

conducting zone of the airway
Nose, trachea, bronchi

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7
Q

what is physiologic dead space

A

airway deadspace and alveolar dead space

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8
Q

high speed time capnography

A

user can interpret information about each breath

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9
Q

slow speed time capnography

A

appreciation of the expired and inspired trend

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10
Q

what is side stream

A

aspirated gas sample and analyzes away from airway at a rate of 50-200mL/min

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11
Q

what is mainstream

A

analyzes gas sample directly in the breathing circuit
no time delay; rise time is faster

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12
Q

where is end tidal CO2 measured during the waveform

A

end point of phase III

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13
Q

causes of increased PetCO2; increase CO2 production and delivery to the lungs

A

increased metabolic rate
fever
sepsis
seizures
malignant hyperthermia
thyrotixicosis
increased CO (due to CPR)
bicarb administration

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14
Q

increased PetCO2; decrease alveolar ventilation

A

hypoventilation
respiratory center depression
partial muscular paralysis
neuromuscular disease
high spinal anesthesia
COPD

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15
Q

increased PetCO2; equipment malfunction

A

rebreathing
exhausted CO2 absorber
faulty inspiratory expiratory valve

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16
Q

decrease PetCo2; decrease CO2 production and delivery to the lungs

A

hypothermia
pulmonary hypo perfusion
cardiac arrest
pulmonary embolism
hemorrhage
hypotension

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17
Q

decreased PetCO2; increase alveolar ventilation

A

hyperventilation

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18
Q

decrease PetCO2; equipment malfunction

A

ventilator disconnect
esophageal intubation
complete airway obstruction
poor sampling
leak around endotracheal tube cuff

19
Q

what is the difference between PaCO2 and ETCO2

A

5mmHg

20
Q

3 problem the increase the difference of PaCO2 and ETCO2

A

V/Q mismatching (PE, endobronchial intubation)
breathing patterns that fail to deliver alveolar gas at the sampling site (neonates, COPD, bronchospasm)
problems with the capnograph (sampling line leak, calibration error, slow response time relative to breathing pattern)

21
Q

Clinical measurement most commonly relies on

A

IR light absorption techniques

22
Q

the greater the CO2 in the sample the _______ IR light that reaches the detector

A

less

23
Q

with the chemical indicator, purple color change indicates

Yellow?

A

no CO2- purple
CO2 - yellow

24
Q

Phase 1 of the capnograph

A

baseline
exhalation of anatomical DS and the apparatus
NO CO2

25
Q

phase 2 capnograph

A

expiratory upstroke begins, CO2 rich alveolar gas
sampling of alveolar gases
normally steep

26
Q

phase 3 capnograph

A

plateau phase
normally representative of CO2 in alveolus
can be representative of ventilation heterogeneity, slight increasing slope

27
Q

phase 0 capnography

A

also called phase IV
inspiration of fresh gas remaining CO2 washed out
downstroke returns to baseline

28
Q

what happens in the occasional phase IV

A

sharp upstroke in PCO2 at the very end of phase III
results from closure of lung units with lower PCO2
Allows for regions with higher CO2 to contribute to more of the exhaled gas sample
seen in pregnant and obese patients with decreased FRC and lung capacity

29
Q

alpha angle separates_____?
what is the angle?
when will increase?

A

separates phase II and III
100-110 degrees
increases with expiratory airflow obstruction (COPD, bronchospasm, kinked ETT)

30
Q

beta angle separates?
degree?
increases with?

A

separates phase III and 0
90 degrees
malfunctioning inspiratory unidirectional valves, rebreathing and low tidal volume with rapid respiratory rate

31
Q
A

mechanical ventilation

32
Q
A

spontaneous ventilation

33
Q
A

inadequate seal

34
Q
A

faulty inspiratory valve

35
Q
A

sample line leak

36
Q
A

hyperventilation

37
Q
A

hypoventilation

38
Q
A

airway obstruction

39
Q
A

cardiac oscillations

40
Q
A

NMBD wearing off

40
Q
A

rebreathing soda lime exhaustion

41
Q
A

over breathing

42
Q
A

esophageal intubation

Principles I summer 2024 (7 decks)

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