H_Obstructive

Question 1

Qual seria a relação entre Ppico , Pplateau e um acometimento de DPOC / Asma ?

Answer 1

Checking the plateau pressure (Pplat) confirmed that this was a resistance problem, rather
than a pure compliance problem.
Her PIP was 39 at the time the inspiratory hold was
performed, but her Pplat was only 28.

The delta between 39 and 28 indicates a significant
resistance component.

Question 2

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Answer 2

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Question 3

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Answer 3

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Question 4

Quais seriam os settings ideais do ventilador para asmático ?

Com relação ao pH , o quao baixo o mesmo pode ser ?

Answer 4

I: E -> > 1:3 or less

6 - 14 breaths/minute, allowing for
permissive hypercapnia

Tidal Volume -» 6-8ml/kg

permissive hypercarbia ->

PaCO 2 > 40 mm Hg and a pH > 7.20
to 7.25

Question 5

Paciente com DPOC de espectro bem enfisematoso. Houve falha no uso de CPAP e agora ele foi intubado.
Como devem ser os parâmetros da VM?

Answer 5

6-8 ml/kg PBW
Respiratory Rate 6 - 20 breaths/minute, allowing for
permissive hypercapnia

FiO 2 Decrease as tolerated, SpO 2 target 88-92%

PEEP 5 - 15 cm H 2 O - may need to match
autoPEEP for patients with significant
emphysematous physiology !!!!