Mechanical Ventilation Flashcards
Avea
Describe APRV?
Airway pressure release ventilation
pt can breathe anytime
improves recruitment and FRC
PB 840
Describe Bilevel
Varying levels of pressure btw a “low” and a “high”
pt can breathe anytime
improves recruitment and FRC
5
Ventilation and Tx steps for ARDS?
1 - ARDSnet
2 - APRV/Bilevel
3- Prone positioning
4 - Inhaled pulm. vasodilators (iNO)
5 - ECMO
Ideal PEEP/ driving pressures <15
What PF ratio should we think about proning in ARDS
PF<150
How do pulm. vasodilators help cardiac?
Cor Pulmonale as part of ARDS. Dilates pulm. vasc (decrease FVR). Helps Right ventricle
think ARDS
ECMO favored conditions?
- Severe hypoxemia mixed condition
- Severe unilateral condition
- Bridging to lung transplant
Vents as a flow controller? True or Flase
True!
What does pressure have to conteract with ventilation?
1) Resistance of tubing + airways
2) Elastic recoil of lung+ chest wall
2 - how does it work
Features of VC+?
1- single breath test-decelerating flow pattern + plateau to determine compliance
2- Targets a pressure rather than volume and adjusts if volumes not obtained (by 3 cmh20 increments)
PRVC (Servo) Auto Flow (Drager)
benefits/ negatives
Features of VC+
- gentle swings in pressure
- adjusts to lung compliance
- Not great for erratic breathing patterns
- No air hunger
3
VC features?
1 - targets volume and cycles regardless of compliance
2 - Sets “Flow” - pt can get air hungry
3 - Decelerating flow - comfortable and initially fills large airways
DOPE acronym?
What is use?
High Vent pressures
Displacement
Obstruction
Pneumothorax
Equipment Failure
Fi02 for proning?
Prone when you can’t wean <0.60 for 24hrs, consider transfer if rural right away
VC+
AVAPS? define and how it works
Average volume assured pressure support
Similar to VC+, changes over minutes, 0.5cmH20 increments
When to use Pressure control ventilation?
- LEAKS!!
(Cuffless ETT, Chest tubes) - Lung protective
- Increased oxygenation
