ICU

Question 1

What is assist control ventilation?

Answer 1

Question 2

What is Synchronized Intermittent-Mandatory Ventilation (SIMV)?

Answer 2

Question 3

Disadvantages of SIMV?

Answer 3

Increased work of breathing
Reduces cardiac output

Question 4

A patient has respiratory muscle weakness and left ventricular dysfunction, what is the best mode of ventilation to use on them?

Answer 4

ACV

Question 5

Patients who breathe rapidly on ACV should switch to _______

Answer 5

SIMV

Question 6

What are disadvantages to pressure control ventilation?

Answer 6

Question 7

Pressure support ventilation?

Answer 7

Question 8

In Pressure Controlled Inverse Ratio Ventilation (PCIRV), the majority of the time is spent in higher/lower inspiratory pressure?

Answer 8

higher

Question 9

How is Airway Pressure Release Ventilation (APRV) different than PCIRV?

Answer 9

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

Question 10

Pressure Regulated Volume Control (PRVC)?

Answer 10

A volume target backup is added to a pressure assist-control mode

Question 11

What is ´Proportional Assist Ventilation (PAV)?

Answer 11

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

Question 12

PEEP increases/decreases intrathoracic pressure and cardiac output?

Answer 12

Increases

Question 13

When can PEEP be dangerous?

Answer 13

hypovolemia or cardiac dysfunction

Question 14

Risk of barotrauma is dependent on Ppeak, while cardiac output response depends on Pmean? True or False

Answer 14

True

Question 15

The effects of PEEP can also be monitored by tracking the PaO2/FiO2ratio, would it increase or decrease?

Answer 15

Increase

Question 16

Good steps to take when weaning a patient?

Answer 16

Question 17

High Frequency Oscillatory Ventillation is also known as?

Answer 17

Lung protective ventilation
Can be used with other respiratory settings

Up to 150breaths/min of small tidal volume

Question 18

When is High Frequency Percussive Ventilation (HFPV) indicated?

Answer 18

Question 19

Simple transition to spontaneous breathing definition

Answer 19

Successful first trial, followed by discontinuation of mechanical ventilation

Question 20

A difficult transition to spontaneous breathing is defined as?

Answer 20

Three spontaneous-breathing trials but fewer than 7 days between the first unsuccessful trial and successful discontinuation of mechanical ventilation

Question 21

A prolonged transition to spontaneous breathing is defined as?

Answer 21

Three spontaneous-breathing trials but fewer than 7 days between the first unsuccessful trial and successful discontinuation of mechanical ventilation

Question 22

What are some reasons spontaneous breathing trials often fail?

Answer 22

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

Question 23

In both septic shock and decompensated hemorrhagic shock, nitric oxide production is increased/decreased?

Answer 23

Increased

Question 24

Name three risk factors for unsuccessful discontinuation of mechanical ventilation?

Answer 24

Question 25

As shock worsens, the initially very high concentrations of vasopressin in plasma increases/decreases?

Answer 25

Decreases

Question 26

How do pressors respond in a deficiency of vasopressin?

Answer 26

Question 27

What is refractory vasodilatory shock?

Answer 27

Question 28

Best initial treatment for shock?

Answer 28

Fluid resuscitation
Norepinephrine

Vosopressin or epinephrine can be added

Question 29

Potential rescue therapies for refractory shock?

Answer 29