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Anesthesiology > Mechanical Ventilation > Flashcards

Mechanical Ventilation Flashcards

1
Q

Movement of gas in and out of alveoli and defined as the maintenance of normal arterial blood carbon dioxide concentration of 35-45 mmHg is known as what?

A

Normal ventilation

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2
Q

What is eupnea?

A

Normal respiration

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3
Q

What is dyspnea?

A

Difficult or labored breathing.

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4
Q

What is tachypnea?

A

Excessively rapid respiration.

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5
Q

What is bradypnea?

A

Abnormal slowness of breathing.

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6
Q

An abnormal breathing pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing is known as what?

A

Cheyne-Stokes respiration

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7
Q

An abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea is known as what?

A

Biot’s respiration

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8
Q

A deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis but also kidney failure is known as what?

A

Kussmaul breathing

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9
Q

An abnormal breathing pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release is known as what?

A

Apneustic respiration

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10
Q

Air in the lungs can be divided into what 4 different volumes?

A
  • Tidal volume
  • Inspiratory reserve volume
  • Expiratory reserve volume
    Residual volume
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11
Q

Air in the lungs can be divided into what 4 different capacities?

A
  • Inspiratory capacity
  • Functional residual capacity
  • Vital capacity
  • Total lung capacity
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12
Q

Inspiratory capacity is equal to what?

A

Tidal volume + Inspiratory reserve volume

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13
Q

Functional residual capacity is equal to what?

A

Expiratory reserve volume + Residual volume

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14
Q

Vital capacity is equal to what?

A

Inspiratory reserve volume + Tidal volume + Expiratory reserve volume

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15
Q

Total lung capacity is equal to what?

A

Inspiratory reserve volume + Tidal volume + Expiratory reserve volume + Residual volume

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16
Q

What are 2 things that can be measured with a spirometer?

A
  • Tidal volume

- Vital capacity

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17
Q

Minute ventilation is equal to what?

A

Tidal volume x Respiratory frequency

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18
Q

What is the minute ventilation of a patient that has a tidal volume of 250 mL and a respiratory rate of 12 bpm?

A

3,000 mL/mg

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19
Q

What can alter the patient’s ability to normally ventilate?

A

Anesthetic drugs

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20
Q

What is required for inhalant anesthetics to be properly taken up and eliminated?

A

Ventilation

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21
Q

What can maintain a smooth and stable plane of anesthesia?

A

Controlled ventilation

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22
Q

What is hypercapnia?

A

Increased level of CO2.

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23
Q

What directly causes vasodilation of peripheral arterioles and myocardial depression?

A

Hypercapnia

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24
Q

Hypercapnia can lead to increased intracranial pressure due to what?

A

Vasodilation

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25
Q

Does hypercapnia directly or indirectly increase circulating catecholamines?

A

Indirectly

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26
Q

Narcosis progresses with PaCO2 values above what level?

A

95 mmHg

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27
Q

Complete anesthesia is induced at what level?

A

245 mmHg

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28
Q

IPPV stands for what?

A

Intermittent positive pressure ventilation

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29
Q

IMV stands for what?

A

Intermittent mandatory ventilation

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30
Q

PEEP stands for what?

A

Positive end-expiratory pressure

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31
Q

CPAP stands for what?

A

Continuous positive airway pressure

32
Q

Positive pressure is maintained only during what?

A

Inspiration

33
Q

An operator sets a predetermined number of positive breaths, but patient can also breathe spontaneously with what form of ventilation?

A

Intermittent mandatory ventilation

34
Q

What is applied when positive pressure is maintained between inspirations that are delivered by a ventilator?

A

Positive end-expiratory pressure

35
Q

Spontaneous breathing with positive pressure during both inspiratory and expiratory cycles is known as what?

A

Continuous positive airway pressure

36
Q

Closing the pop-off valve and squeezing the reservoir bag until 10-20 cm H2O is reached and then the pop-off valve is reopened so the patient can passively expire is known at what?

A

Manual intermittent positive pressure ventilation

37
Q

What are 6 reasons a patient might require mechanical ventilation?

A
  • Respiratory center depression
  • Inability to adequately expand thorax
  • Airway obstruction
  • Inability to adequately expand lungs
  • Cardiopulmonary arrest
  • Pulmonary edema or pulmonary insufficiency
38
Q

Is negative pressure generated during inspiration with mechanical ventilation?

39
Q

What might IPPV physically impede?

A

Venous return to the right side of the heart.

40
Q

The CV effects of mechanical ventilation can be overcome often with what?

A

Expansion of extracellular fluid volume and administration of inotropic drugs.

41
Q

Excessive or sustained pressure from IPPV can lead to what?

A

Over expansion and volutrauma.

42
Q

What is tidal volume in small animals?

In large animals?

A
  • 10 to 20 mL/kg

- 15 mL/kg

43
Q

What is inspiratory time for small animals?

For large animals?

A
  • 1 to 1.5 sec

- 1.5 to 3 sec

44
Q

What is the I:E ration for small animals?

For large animals?

A
  • 1:2 to 1:3

- 1:2 to 1:4.5

45
Q

What is the peak inspiratory pressure (PIP) for small animals?
For large animals?

A
  • 15 to 20 cm H2O

- 20 to 30 cm H2O

46
Q

What is the respiratory frequency for dogs?
For cats?
For horses & cows?
For pigs & small ruminants?

A
  • Dogs: 8 to 14 bpm
  • Cats: 10 to 14 bpm
  • Horses & cows: 6 to 10 bpm
  • Pigs & small ruminants: 8 to 12 bpm
47
Q

T/F: The tidal volume for IPPV is usually increase above normal spontaneous tidal volume to compensate for pressure-mediated increases in volume of the breathing system and airway.

48
Q

Patients with what 3 conditions may need to have an increased respiratory rate to maintain minute ventilation without creating excessive inspiratory pressures?

A
  • Lung trauma
  • Diaphragmatic hernia
  • Gastrointestinal distention
49
Q

The amount of gas delivered to a patient depends on several factors including these 2.

A
  • Resistance & compliance of breathing system

- Patient’s respiratory system

50
Q

Although inspiratory pressure may not vary over time, what may change as compliance of the respiratory system changes?

A

Tidal volume

51
Q

A certain level of what is required to stimulate ventilation?

52
Q

If PaCO2 is low, what may not return?

A

Spontaneous ventilation

53
Q

Opioids, anesthetics, neuromuscular blocking drugs, hypothermia or hypovolemia may have what effect?

A

Delay return of consciousness and therefore spontaneous ventilation.

54
Q

The patient should continue to receive supplemental O2 and can be manually ventilated at what rate until spontaneous ventilation has returned and stabilized?

A

1 to 4 bpm

55
Q

What are 3 classifications of ventilator?

A
  • Volume cycled
  • Pressure cycled
  • Time cycled
56
Q

Which classification of ventilator is the most frequently used in vet medicine?

A

Time cycled

57
Q

Which type of ventilator inflates lungs to a predetermined volume?

A

Volume cycled

58
Q

Which type of ventilator inflates lungs to a predetermined pressure?

A

Pressure cycled

59
Q

The fact that inspiratory pressure may increase if compliance decreases during ventilation is a disadvantage of which ventilator?

A

Volume cycled

60
Q

The fact that tidal volume delivered may decrease if respiratory compliance decreases in a patient is a disadvantage of which ventilator?

A

Pressure cycled

61
Q

Which type of ventilator inflates lungs for a preset time at a predetermined gas flow rate?

A

Time cycled

62
Q

Ascending or “standing” bellows rise during which phase?

A

Expiratory

63
Q

Descending or “hanging” bellows fall during which phase?

A

Expiratory

64
Q

With which type of bellow is it easy to detect leaks because because bellows do not return to full height?

A

Ascending or “standing” bellows

65
Q

Which type of bellow may continue to cycle even with complete disconnection of ventilator from breathing system?

A

Descending or “hanging” bellows

66
Q

What is an ambu bag used for?

A

IPPV of small animals with room or supplemental O2

67
Q

What can be inserted on the proximal end of endotracheal tube to deliver IPPV?

A

Demand valve

68
Q

What is used to re-inflate collapsed alveoli by applying a sustained pressure above normal PIP and using PEEP to prevent derecruitment?

A

Recruitment maneuver

69
Q

How frequently can a sigh breath be administered?

A

Once every 5 minutes

70
Q

A large positive pressure breath held for 10-15 seconds is known as what?

71
Q

What might be useful to recruit collapsed alveoli and might improve oxygenation?

72
Q

What can develop with prolonged exposure to high O2 concentrations?

A

Oxygen toxicity

73
Q

What are 3 things oxygen toxicity can lead to?

A
  • Pulmonary dysfunction
  • Pulmonary edema
  • Death
74
Q

What level of oxygen is considered generally safe to administer for prolonged administered?

75
Q

What needs to be opened at the end of IPPV?

A

Pop-off valve

76
Q

Maintaining normal ventilation is an important aspect of providing safe general anesthesia since most anesthetized patients do what?

A

Hypoventilate

77
Q

When should the ventilator be set up?

A

Before the patient is induced.

Anesthesiology (19 decks)

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