HFV Flashcards
W/HFV, are the potential hazards of Mechanical ventilation eliminated?
No.
RCT’s show _____ advantage of HFV vs. CMV
No advantage
HFV is used with rates greater than_____/minute.
> 150 breaths/minute
-conventional vents are not allowed to go over 150 breaths/minute
With HFV, _____ _____ is smaller than the dead space
Tidal Volume
Oxygenate w/what HFV settings?
MAP/FRC
Is FRC w/HFV still crucial?
Yes
Oxygenation depends upon what with HFV?
MAP & FiO2
FRC is how you __________.
Oxygenate
Does the JET vent oxygenate the baby?
No, it’s the CMV connected to the JET that oxygenates baby (CPAP, PEEP, FiO2)
What is the ONLY thing you do with a JET ventilator?
Remove CO2
Would you ever place a baby on JET just for poor oxygenation?
No
W/JET vent, where do you read MAP?
On the JET vent
______ is often the most critical value in determining optimal gas exchange (oxygenation) as it correlates with lung volume.
MAP (to maintain FRC)
W/the JET vent, you have to go up on the _____ to maintain the MAP
PEEP
Don’t let the _____ fall when initiating JET vent
MAP
To avoid barotrauma caused by increased ____when using the JET vent, increase ______, and decrease _____.
Vt
PEEP
PIP
Alveolar MV = ____- dead space x RR. You should not be able to ventilate with HFV, but you can.
Vt
Hz=
1/sec or 60/min
HFV Vt’s are ______
small
w/HFV, ventilation happens via ______ _______
facilitated diffusion
Facilitated diffusion makes it easier to ______ the molecules of _____ very ______.
disperse
CO2
quickly
You must have a _______ airway for facilitated diffusion to work
clear airway
HFV via JET vent is a continuous _______ of gas through an ________, humidification is _________.
stream
injector
difficult
An oscillator uses ____Vt’s, rapid rate, and _________ exhalation via a piston (pushes and pulls gas in/out).
small
facilitated
With a Jet, the constant stream of gas is always ___ never ___.
It’s ___-off-__-off.
In never out
In/off/in/off
T/F: With Jet ventilation there’s a limit to how fast you can ventilate.
Why or why not?
True
B/c you need passive exhalation
The oscillator is the only vent to use what kind of exhalation
Active exhalation
_____ exhalation is better at getting rid of CO2.
Active (so HFV vs. JET)
W/active exhalation, there may be ______ (choke points).
collapse–> air trapping
With a homogenous lung and an open airway, turn up the ____ until they are oxygenated.
MAP
A non-homogenous lung is much better to use with the _____ ventilator.
JET
A recruiting breath is also called a ____ breath
Sigh
With MAS you get _________ & _________.
Overinflation
Atelectasis
With HFV, ventilation (removing CO2) depends on ______ (Vt) and Rate.
AMP
Is it easy or difficult to overinflate w/HFO?
Easy
w/HFO, _____ controls CO2
Amplitude
w/HFO, Rate is _________ r/t PaCO2
Inversely related (the piston has more time to move a greater volume, the Vt increases so much more)
It is ____________ to use a sigh breath when you have air leaks w/JET vent.
contraindicated
The PIP on the conventional vent is to ______ lung, the PIP on the Jet vent is to ______ CO2.
Recruit
Remove
Why doesn’t a high PIP on JET vent injure the lung?
It doesn’t transmit to the Alveoli b/c the IT is about 0.02 seconds.
Vt’s w/JET vent are approx ____ times smaller than conventional vent Vt’s
10 times smaller–allowing higher levels of PEEP to be used safely to maintain open lungs and MAP for oxygenation
Is servo pressure a pressure?
No–it’s the amount of gas that it takes to do what you just told the JET to do. (amt of gas the ventilator is requiring)
W/increased Servo pressure, there is perceived _________ in lung volume/compliance/resistance.–there is more volume to ventilate.
Increase
W/decreased Servo pressure, there is perceived ________ in lung volume/compliance/resistance.
Decrease
When might you see an elevated Servo pressure?
Air leak around ETT, pneumothorax, circuit tubing leak
When might you see a decreased Servo pressure?
Obstructed ETT, Tension Pneumo, Rt. Mainstem, Pt needs suctioning
The goal with weaning off the JET vent is to ___________.
Extubate. You do not need to wean to CMV first.
