Ch. 13 Pilbeams

Question 1

Breathing 100% oxygen can lead to_______ and increase intrapulmonary shunting which further contributes to hypoxemia?

Answer 1

Absorption atelectasis

Question 2

What is the target PaO2 and SPO2 for adults?

Answer 2

PaO2 = 60 mmHg & SpO2=90%

Question 3

One approach that can be used to increase PaO2 involves increasing what?

Answer 3

Airway pressure

Question 4

What are some factors that affect airway pressure during positive pressure ventilation?

Answer 4

• PIP
• PEEP
• I:E ratio
• RR
• Inspiratory flow pattern

Question 5

What are some goals of PEEP & CPAP

Answer 5

1. Maintain a PaO2 of 60mmHg or greater and SpO2 at 90 or greater, and acceptable pH
2. Recruit alveoli and maintain them in an aerated state.
3. Restore FRC
4. Enhanced tissue oxygenation

Question 6

What is the minimum PEEP level? This will help preserve a patient’s what?

Answer 6

3 to 5 cmH2O; FRC

Question 7

Therapeutic peep is______ or greater?

Answer 7

5cmH2O

Question 8

What is therapeutic PEEP used to treat?

Answer 8

Refractory hypoxemia caused by increased intrapulmonary shunting and V/Q mismatching accompanied by decrease FRC and pulmonary compliance

Question 9

Greater than or equal to ______ of therapeutic PEEP is beneficial for a small percentage of the patients with ARDS?

Answer 9

15cmH2O

Question 10

What are some indications for PEEP?

Answer 10

• bilateral infiltrates on chest radiograph
• reduced lung compliance
• recurrent atelectasis with low FRC
• PaO2 of less than 60 mmHg on FiO2 greater than 50%
• PF ratio less than 300 for ARDS

Question 11

What is a refractory hypoxemia?

Answer 11

When PaO2 increases less than 10 mmHg with an FIO2 increase of 20%

Question 12

What are some disorders that will benefit from PEEP?

Answer 12

• ARDS
• cardiogenic pulmonary edema in adults and children
• bilateral diffuse pneumonia