Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RT-131B - FInal Sem > Effects of PPV > Flashcards

Effects of PPV Flashcards

1
Q

What can decrease Coronary Blood Flow with PPV?

A
  • Decreased CO or Decreased BP

- Increased Intrathoracic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does peep do to MAP

A

Peep adds to MAP 1 to 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What other organs are effected by PPV

5 things

A
  • ICP and Cerebral Perfusion
  • GI bleeding,
  • Ulcers
  • Liver dysfunction
  • Decreased Blood flow to kidneys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 Renal Effects

A

1) Redistribution of renal flow
2) Increase in Anti-Diuretic Hormone (ADH)
3) Decreased secretion of Atrial Natriuretic Peptide (ANP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes reduced overall blood flow in kidney?

A

Lowered BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is blood flow redistributed in kidney in the presence of PPV?
What Occurs when this happens?

A
  • Flow to inner cortex is less

- More Na is reabsorbed (and with it comes water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Increasing ADH equates to?

A

Fluid retention and Decreased Urinary Output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes an increase in ADH?

A
  • Decreased Left Atrial volume

- Decreased Blood Pressure via the Carotid and Aortic baro receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What releases Atrial Natriuretic Peptide and what does it cause?

A

Atria distention which then causes diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

a PaO2 and CO2 of what can cause an effect of the kidney?

A

PaO2 < 40

CO2 > 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What GI function is effected?

A
  • Liver malfunction
  • Gastric mucosal ischemia
    • Critical patients may have gastric ulcers
    • Treat with antacids or histimine H2 blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the types of Ventilator-Associated Lung Inuries?

5 things

A
  • Barotrauma
  • Volutrauma
  • Atelectrauma
  • Biotrauma
  • Multiple-Organ Dysfunction Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the Predispositions of Barotrauma?

6 things

A
  • High Pressures
  • Blebs
  • High PEEP
  • Aspiration of Gastric Acid
  • Necrotizing Pneumonia
  • ALI/ADS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the effects of PPV on Gas Distribution and Pulmonary Blood Flow
6 things

A
  • Ventilation to Nondependent Lung
  • Ventilation to Lung Periphery
  • Increase in Dead Space
  • Redistribution of Pulmonary Blood Flow
  • High levels can increase PVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are hazards of Oxygen Therapy with Mechanical Ventilation?
3 things

A
  • Oxygen Toxicity
  • Absorption Atelectasis
  • Depression of Ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What a happens to the atria during PPV?

A

Reduced atrial stretch during PPV

This causes less ANP to be released = less diuresis

17
Q

Describe the Throacic Pump Mechanism between PPV and Spont breathing

A

during spont breathing, the lungs go more negative and increases venous return

During PPV, the lungs go positive and venous return decreases

18
Q

What is an adverse effect of PPV to the pulmonary vascular resistance?

A

excessive stretch of lungs can stretch the capillaries and increase the PVR

Increased PVR can cause stretch of Right heart leading to ventricular septal deviation and shrinking of left ventricle, IF THE RIGHT HEART CANT OVERCOME IT.

19
Q

What can PPV do in the presence of Left heart failure causing pulmonary edema?

A

PPV can decrease venous return

Decreases in CO can over time decrease preload in left ventricle.

Resting the left heart

20
Q

What during PPv can affect Coronary Blood flow?

A

Decreased CO or Decreased BP

therefore decreased pressure gradient for coronary flow - You need good diastolic pressure for it.

increased Intra thoracic pressure - This compresses the heart

21
Q

How can you minimize the effects of PPV?

A
  • Shorter I-times
  • Lower Pips
  • Keep an Eye in MAP and the amount of Peep you use
22
Q

What is the equation for Mean Airway Pressure (PAW)?

A

MAP = [0.5(PIP-PEEP) x (I Time/ TCT)] + PEEP

23
Q

What can PPV do to gastrointestinal system?

A

Positive pressure-induced splanchnic hypoperfusion causing gastric bleeding leading to ulcers

Liver dysfunction due to pressure from diaphragm above (Liver cell damage)

24
Q

What do decreases in CO and SV cause within the body?

A

increases in sympathetic response (vasoconstriction)

This results in increase in HR to compensate
Many pts have this prior to vent – then as we correct hypoxemia, acidosis, it decreases and hypotension can result

25
Q

What is biotrauma?

What does this lead to?

A

It is a release of inflammatory mediators that cause a systemic inflammatory response to non pulmonary organs.

Leads to Multiple-Organ Dysfunction Syndrome

This is caused by Volutrauma, Barotrauma, or Atelectrauma in the lungs.

RT-131B - FInal Sem (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions