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Interventions 2 (RESP 319) > LVRM CBO > Flashcards

LVRM CBO Flashcards

1
Q

Add slide 3 in

A
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2
Q

What is the main purpose of a Lung Volume Recruitment Maneuver (LVRM)

A
  • Improve gas exchange
  • Attenuate ventilator-induced lung injury (VILI(
  • Increase lung compliance
  • Minimize Physiologic deadspace
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3
Q

How are Lung Volume Recruitment Maneuver (LVRM) performed/entail?

A

Applying sustained inflation or Intermittent signs

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4
Q

What are the aims and goals of sustained inflation?

A

Aims to cause incremental improvement in oxygenation if pressure are adequate.

  • may achieve optimal ventilation lung volumes
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5
Q

Why is sustained inflation a preferred method of Lung Volume Recruitment Maneuver (LVRM)?

A

Minimical complications w/good success prognosis in infants.

  • not a definitely superior technique
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6
Q

How is optimal PEEP determined?

A

By comparing the lower and upper (LIP and UIP) of the pressure volume (PV) curve.

  • aiming for the…?
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7
Q

What are indications for Lung Volume Recruitment Maneuvers (LVRM)?

A
  • After disconnection from the ventilator
  • after suctioning
  • evidence of atelectasis
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8
Q

What are contraindications for Lung Volume Recruitment Maneuvers (LVRM)?

A

Chest tubes or air leak

  • evidence of barotrauma, pneumothorax, subcutaneous emphysema, pulmonary intestinal emphysema (PIE)
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9
Q

How is sustained inflation performed?

A

Apply excess of expected alveolar opening pressures for periods of 5-30 secs

  • aka apply CPAP for 30s
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10
Q

what CPAP levels should be applied during sustained inflation for differing patient weights?

A
  • Less than 10 kg = 30 cmH2O
  • 10 – 30 kg = 35 cmH2O
  • > 30 kg = 40 cmH2O
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11
Q

What is the procedure for Intermittent sighs?

A

Supplementing several breaths

  • PEEP 2-5 cmH2O higher
  • PIP around 30 cmH2O (weight dependant)
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12
Q

What level of CPAP should be used for Intermittent Sighs?

A
  • Less than 10 kg = 30 cmH2O
  • 10 – 30 kg = 35 cmH2O
  • > 30 kg = 40 cmH2O
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13
Q

When should you discontinue a patients Lung Volume Recruitment Maneuver (LVRM)?

A

If the patient desaturates or HR changes by 20%

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14
Q

What should you monitor for a Lung Volume Recruitment Maneuver (LVRM)?

A

SpO2, EtCO2, and HR.

  • May be useful to do low flow inflection point analysis
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Interventions 2 (RESP 319) (25 decks)

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