Chapter 15 Flashcards
CPAP
1
Q
- What is CPAP? and What is abbreviated?
A
- spontaneous ventilation with positive pressure applied to the airway t/o the respiratory cycle.
- Continuous Positive Airway Pressure.
2
Q
- What is Physiological effects of CPAP?
A
- Increase FRC
- Increase compliance
- Decrease total airway resistance
- Decrease respiratory rate
- Decrease WOB
- Decrease intrapulmonary shunting
3
Q
- What is Indication of CPAP?
A
Indications
- PaO2 < 50 on FiO2 60% or more with adequate ventilation
- Premature infants
- apnea of prematurity
- Obstructive airway disease
- Pneumonia
- Meconium
- CHF/Pulmonary edema
- TTN
- Paralysis of diaphragm
4
Q
What is Contraindications for CPAP?
A
- PaCO2 >60 and ph <7.25
- Upper airway abnormalities
- Congenital diaphragmatic hernia
- Neuromuscular disease.
- CNS depression
- Central or frequent apnea
5
Q
- What are Hazards and Complications of CPAP?
A
- Decreased cardiac output
- Decreased renal function
- Increased ICP
- Barotrauma
- Nasal CPAP may result in: nasal obstruction or necrosis and gastric distension
6
Q
- What are the Equipment of CPAP? Four things
A
pt interface
- nasal prongs
- E.T. tubes
- masks nasopharyngeal tubes
- head box
7
Q
- How many CPAP Generators are there? Three things to know
A
- Flow systems
- Stand alone CPAP machines
- Mechanical ventilators
8
Q
How to know if CPAP has failed? Six things to know
A
- PaO2 < 50 & FiO2 0.80-1.0
- CPAP > 8-12 cmH2O
- PaCO2 > 60 with acidosis
- pH <7.25
- Marked retractions/nasal flaring/retractions on CPAP
- Frequent apnea
9
Q
- When is it ready for Weaning from CPAP? Three things to know
A
Patient with clinical improvement
- Decreases FiO2 to 0.40 -0.60
- Decreases CPAP by 2cmH2O increments as tolerated by pulse ox or ABG’s
- At CPAP of 2-3 cmH2O may extubate
10
Q
SiPAP
A
- Spontaneous breathing at two levels (sort of like APRV) Not synchronized
Sigh breath
- Ti 1-3 seconds
- Rate sets now often
- Breaths spontaneously through Ti 2-3 cmH2O above baseline
- Recruits alveoli
