HFO Flashcards
Criteria for possible exit to HFV?
- RR > 80
- Vt > 5
- PIP > 25
- MAP > 23 and FiO2 >0.40
Trigger, Limit, and cycle for the HFO mode?
- Time triggered
- Pressure limited
- Time Cycled
Generally, what are traits of HFO?
- Very high rates (500-1200bpm)
- Low Vt (neos 1.8-2ml/kg)
- High Mean Airway Pressures (PEEP)
HFO control settings?
- Mean Airway Pressure (PEEP)
- Amplitude (Vt)
- % inspiratory Time (33%)
- Frequency (Hz) (Rate1 Hz = 60 Breaths/min)
- Bios Flow
What do waveforms look like for HFO?
Really fast and squiggly
Initial Settings for HFO when trying to Optimal Lung Recruitment ?
- Set MAP 2-3 cmH2O higher than MAP on conventional vent
- make 1-2 cmH2O MAP changes until oxygenation improves
- Set RR as needed (10hz for term, 12-15 for preterm)
Initial Settings for HFO when aiming for Low Volume?
- Set MAP equal to MAP on conventional Ventilator
- Set frequency as needed (higher frequencies are more lung protective)
How do you wean a pt off of HFO?
- Ensure FiO2 < 0.40 before weaning MAP
- Reduce MAP by 1-2cmH2O until at 8-10cmH2O
- Wean amplitude by 2-4
- Do not wean frequency
- Switch to conventional ventilation when MAP is 8-10cmH2O and amplitude is 20-25
Making adjustments: When would you increase/decrease HFO settings to correct poor ventilation?
Need to add slide 11
To correct poor ventilation you can either increase amplitude or decrease frequency
Making adjustments: When would you increase/decrease HFO settings to correct over ventilation?
Decrease amplitude and Increase Frequency
Making adjustments: When would you increase/decrease HFO settings to correct poor oxygenation?
Increase FiO2 and Increase MAP
Making adjustments: When would you increase/decrease HFO settings to correct over oxygenation?
Decrease FiO2 and Decrease MAP
What is the RR to start HFV?
More then 80 breaths
What is the Vt to start HFV?
Greater then 6
What is the PIP to start HFV?
Greater then 25
What is the MAP to start HFV?
Greater then 12
What mode should HFO be in?
- Triggers, limits, and cycle for HFO
Time triggered, pressure limited, time cycled
Trigger for HFO?
Time
Limit for HFO?
Pressure
Cycle for HFO?
Time
What are the rates for HFO?
500-1200bpm
What should MAP be in HFO?
MAP should be equal to PEEP
What should MAP be weaned to for HFO?
8-10
What should amplitudes be weaned to for HFO?
2-4
What should you wean frequency be weaned to?
Do not wean frequency
What are the tidal volumes (Vt) for HFO?
1.8-2 mL/kg
