Ch 17: Neo and Peds MV Flashcards
A term infant is being invasively ventilated in the pressure-targeted SIVM mode of ventilation; set rate is 16, PIP is 18, PEEP is 4, Ti is 0.4, and FiO2 is >30, and the physician would like to wean the infant from the ventilator. The clinician has tried turning the patient’s set rate on SIMV down to 10 bpm, but the infant immediately becomes tachypneic and desaturates to 85%. Which of the following should be done at this time?
B. Initiate Pressure Support
A 600g neonate is being mechanically ventilated in pressure control ventilation with the following settings: PIP 24cm H2O, PEEP of 4, FiO2 45%, RR 40bpm. Which Ti should the clinician recommend?
B. 0.3 sec
Which of the following issues would most likely explain why a newborn infant’s measured RR would rise from 40-100bpm on a ventilator after the patient was turned and an audible endotracheal tube leak was heard?
B. Auto-triggering
A 10yo child is intubated and receiving mechanical ventilation. The VT is 280mL, PIP 38cm H2O, Pplat 20 cm H2O, and PEEP of 5 cm H2O. The tubing compliance factor is 1.5 mL/cm H2O. What is the actual delivered VT to this patient if the ventilator does not compensate for compressible volume loss?
C. 230 mL
The physician would like to begin dual-control ventilation of a 500g infant. What would be the initial corrected volume target?
A. 5mL/kg
While observing a ventilator flow graphic for a 12 yo patient with asthma on a rate of 10bpm, the clinician notices that expiratory flow does not return to baseline and the patient’s auto-PEEP level is 6cm H2O. Which ventilator manipulation might help this patient the most?
B> Decrease Ti
A neonatal patient with RSV is receiving mechanical ventilation in the pressure control mode with the following current settings: PIP 14, PEEP 5, FiO2 50%, RR 28. The patient has poor chest rise bilaterally, and breath sounds are udneraerated with faint wheezes bilaterally. You notice that the measured VT is 3 mL/kg and the RR is 80. The patient has nasal flaring, retractions, and head bobbing. What should be suggested at this time?
B. Suctioning and then increasing PIP
Which ventilator approach would be good for a 10yo with severe ARDS who is spontaneously breathing while undergoing ventilation?
B. APRV
Which of the following factors does not affect mean airway pressure?
C. Time Constant
High-frequency ventilation is defined by the FDA as delivering more than:
A. 150 bpm
HFJV delivers a gas by:
B. Pulsing gas down the ETT at a high velocity
HFOV delivers gas by:
D. Passing gas past the endotracheal tube and agitating it with a piston
The exhalation phase of HFOV differs from other forms of high-frequency ventilation because:
A. Exhaled gas is actively pulled out via the patient as the piston moves back.
Which of the following most accurately describes the relationship of lung volume in a restrictive disease and Paw:
- Increasing Paw increases lung volume and improves ventilation- perfusion matching.
- Increasing Paw improves the efficiency of the jet or piston.
- At very high and very low lung volumes, ventilation- perfusion matching is impaired.
The goal in treating atelectatic-prone lung is:
A. High lung volume to recruit alveolar lung units.
