Clinical Perspective of Mechanical Ventilation

Question 1

This type of mechanical ventilation is used to “wean” patients off ventilation.

Answer 1

Synchronized Intermittent Mechanical Ventilation (SIMV)

Question 2

With this type of mechanical ventilation, the patient triggers a partial breath delivered by the machine that they must complete.

Answer 2

Pressure support - this is a means of weaning a patient off mechanical ventilation

Question 3

How does Synchronized Intermittent Mechanical Ventilation (SIMV) work to decrease patient reliance on mechanical ventilation?

Answer 3

The machine has a set RR, but the patient may take breaths between machine breaths. Unlike assist/control, a negative pressure by the patient will not trigger a new machine breath before the set time

Question 4

True/False. With increased positive end expiratory pressure (PEEP) venous return decreases.

Answer 4

True - this leads to hypotension that is generally not tolerated by the patient

Question 5

True/False. Continuous positive airway pressure (CPAP) is a way to push air into a patient.

Answer 5

False - The patient must still create a negative pressure to breath. CPAP raises the air pressure above atmospheric pressure so that a patient can take a larger breath with the same effor

Question 6

True/False. The RR set on an assist/control volume ventilation is the true RR.

Answer 6

False - it may be the true RR, but the patient may also trigger additional breaths so always be sure to check

Question 7

What are the two forms of positive pressure ventilation?

Answer 7

Volume control - a set tidal volume is always delivered and pressure will be adjusted as needed

Pressure control - a pressure is set and tidal volume will vary

Question 8

Which phase of respiration is longer, inspiration or expiration?

Answer 8

Expiration

Question 9

Inverse I:E ventilation is a way to promote oxygen exchange by prolonging inspiration. What complications are associated with this method?

Answer 9

The patient must be sedated. The brain responds unconsciously to positive lung pressure with exhalation.

Positive pressure decreased venous return and filling capacity of the LV. This ultimately leads to hypotension.

Question 10

Volume control ventilation is always set to assist/control. What does this mean?

Answer 10

A tidal volume and RR is set, but the patient can trigger a new breath with a negative pressure before the next set respiration