ICU Flashcards
What is assist control ventilation?
What is Synchronized Intermittent-Mandatory Ventilation (SIMV)?
Disadvantages of SIMV?
Increased work of breathing
Reduces cardiac output
A patient has respiratory muscle weakness and left ventricular dysfunction, what is the best mode of ventilation to use on them?
ACV
Patients who breathe rapidly on ACV should switch to _______
SIMV
What are disadvantages to pressure control ventilation?
Pressure support ventilation?
In Pressure Controlled Inverse Ratio Ventilation (PCIRV), the majority of the time is spent in higher/lower inspiratory pressure?
higher
How is Airway Pressure Release Ventilation (APRV) different than PCIRV?
APRV is a variation of CPAP that releases pressure temporarily on exhalation
Higher airway pressures
Requires increased sedation
Spontaneous ventilation is allowed at high and low pressures
Pressure Regulated Volume Control (PRVC)?
A volume target backup is added to a pressure assist-control mode
What is ´Proportional Assist Ventilation (PAV)?
Clinician sets the percentage of work of breathing and when it triggers
Positive feedback loop that uses intermittent end-inspiratory and end-expiratory pause maneuvers to control breathing
PEEP increases/decreases intrathoracic pressure and cardiac output?
Increases
When can PEEP be dangerous?
hypovolemia or cardiac dysfunction
Risk of barotrauma is dependent on Ppeak, while cardiac output response depends on Pmean? True or False
True
The effects of PEEP can also be monitored by tracking the PaO2/FiO2ratio, would it increase or decrease?
Increase
Good steps to take when weaning a patient?
High Frequency Oscillatory Ventillation is also known as?
Lung protective ventilation
Can be used with other respiratory settings
Up to 150breaths/min of small tidal volume
When is High Frequency Percussive Ventilation (HFPV) indicated?
Simple transition to spontaneous breathing definition
Successful first trial, followed by discontinuation of mechanical ventilation
A difficult transition to spontaneous breathing is defined as?
Three spontaneous-breathing trials but fewer than 7 days between the first unsuccessful trial and successful discontinuation of mechanical ventilation
A prolonged transition to spontaneous breathing is defined as?
Three spontaneous-breathing trials but fewer than 7 days between the first unsuccessful trial and successful discontinuation of mechanical ventilation
What are some reasons spontaneous breathing trials often fail?
Increased respiratory resistance such as that which occurs in status asthmaticus and other obstructive pulmonary conditions
Decreased lung compliance in diseases such as pulmonary fibrosis, pulmonary edema, acute lung injury, or ARDS
Air trapping that can occur in chronic obstructive pulmonary disease
In both septic shock and decompensated hemorrhagic shock, nitric oxide production is increased/decreased?
Increased
Name three risk factors for unsuccessful discontinuation of mechanical ventilation?
As shock worsens, the initially very high concentrations of vasopressin in plasma increases/decreases?
Decreases
How do pressors respond in a deficiency of vasopressin?
What is refractory vasodilatory shock?
Best initial treatment for shock?
Fluid resuscitation
Norepinephrine
Vosopressin or epinephrine can be added
Potential rescue therapies for refractory shock?
