initiation of mechanical ventilation

Question 1

mechanical ventilation

Answer 1

ventilation
oxygenation
circulation
perfusion

Question 2

acute ventilatory failure

Answer 2

uncompensated respiratory acidosis
paco2 trending is essential
if paco2 is marginal and stable use CPAP or BiPap stop-gap measure to avoid intubation

Question 3

impending ventilatory failure

Answer 3

for patients with adequate cardiopulmonary reserve, Paco2 can be low or normal
rapid shallow breathing and tachycardia are common
respiratory muscle fatigue may documented be trending the Paco2, vital signs, and lung mechanics
early intervention maybe necessary to prevent stress and complication

Question 4

tidal volume

Answer 4

3 to 5 mL/Kg

Question 5

minute ventilation

Answer 5

10 L/min

Question 6

vital capacity

Answer 6

> 15 ml/kg

Question 7

Maximam inspiratory pressure

Answer 7

<-20 cmH2o

Question 8

pao2/fio2 < 300 mmhg

Answer 8

threshold for ALI

Question 9

pao2/fio2 < 200 mm Hg

Answer 9

threshold for ARDS

Question 10

tension pneumothorax sign and symptoms

Answer 10

absent BS
hyperresonant percussion
tracheal shift away
sub Q
decrease BP and CO
increase airway pressure

Question 11

volutrauma

Answer 11

related to lung over dissension from larger tidal volume and PEEP and seen as braking on P/V loop

Question 12

atelectrauma

Answer 12

closed alveoli

Question 13

biotrauma

Answer 13

release mediator

edema

Question 14

cadiovascular effect

Answer 14

decrease CO

drop in BP

Question 15

Hepatic effect

Answer 15

decreased portal blood flow during inspiration

leads to blood clots and decrease detoxification on drugs

Question 16

renal effect

Answer 16

decrease urine output

water weight gain from ADH