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Principles III > Mechanical Ventilation > Flashcards

Mechanical Ventilation Flashcards

1
Q

Inverse Ratio Ventilation

A

PCV plus prolong inspiratory time. Decreased insipratory flow rate is used to prolong the time for lung inflation (helps prevent aveolar collapse

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2
Q

Indications for inverse ratio

A

Refractory hypoxemia, or hypercapnia

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3
Q

Inverse ratio settings you can adjust

A

RR, Pressure support, I:E ratio, PEEP, FiO2

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4
Q

Adverse affects of Inverse ratio

A

Can cause Auto PEEP

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5
Q

Pressure Support (PSV)

A

Pt triggers each breath, but a set amount of pressure assists each breath

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6
Q

Indications for PSV

A

Weaning mode, patient only needs airway protection

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7
Q

PSV settings you can adjust

A

Pressure support, PEEP, FiO2

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8
Q

Adverse effects of PSV

A

may not receive adequate tidal volumes

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9
Q

High Frequency Ventilation (HFV)

A

Extremely small tidal volume ventilation with gas exchange occuring via diffusion. Lung is effectively kept open throughout ventilation. AKA open lung

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10
Q

High Frequency Ventilation (HFV) indications

A

Acute resp failure with need to provide lung protection. which prevents (volutrauma)

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11
Q

adverse effects of High Frequency Ventilation (HFV)

A

Very difficult mode of ventilation best used by those with alot of experience

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12
Q

Noninvasive Positive Pressure Ventilation (NPPV) AKA BiPAP

A

Mode used for a spontaneously breathing Pt in which you are trying not to intubate

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13
Q

Noninvasive Positive Pressure Ventilation (NPPV) AKA BiPAP indications

A

Acute resp failure, COPD, CHF, hypercapnic resp failure

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14
Q

Noninvasive Positive Pressure Ventilation (NPPV) AKA BiPAP adverse effects

A

May insuflate the stomach and the patient needs to be awake

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15
Q

Noninvasive Positive Pressure Ventilation (NPPV) AKA BiPAP Settings

A

Insp. pressure and exp. pressure, FiO2

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16
Q

Extrinsic PEEP

A

Prevents alveoli collapsing at the end of expiration and recruits already collapsed alveoli

17
Q

Extrinsic PEEP indications

A

Improve gas exchange and increase lung compliance

18
Q

Extrinsic PEEP adverse effects

A

Reduces cardiac filling and cardiac output, can over distend alveoli causing deadspace

19
Q

Intrinsic PEEP. AKA Auto PEEP

A

caused by prolonged inspirtory times and the vent doesn’t give enough time for full expiration by the Pt

20
Q

Ways to treat Auto PEEP

A

decrease the inspiratory time, increase the expiratory time and increase the PEEP to match the Pts

21
Q

Plateau Pressure

A

The pressure needed at the end of inspiration to keep the alveoli open

22
Q

What is the minimal flow resistance in a typical ETT

A

3-7 cm of H2O/liter/sec

23
Q

Ways to overcome persistent hypoxia

A
  • increase Pt sedation
  • paralytics
  • placing pt in a prone position
  • nitric oxide
  • inhaled prostacyclin
24
Q

What is the greatest predictor of the pt being weaned off the vent

A

the RR/TV ratio

25
Q

Criterior for coming off the vent

A

FiO2 < 0.5 and PEEP (< or =) 7.5 cm H2O

26
Q

Assist Control (AC)

A

The Pt initiates the breath but a set tidal volume is delivered if the Pt doesn’t initiate the breath then a set rate of breathes is delivered

27
Q

Assist Control (AC) Indications

A

Acute Resp failure, ARDS, Pneumonia

28
Q

Assist Control (AC) Settings

A

RR, TV, PEEP, FiO2

29
Q

Assist Control (AC) Adverse effects

A

Resp alkalosis due to hyperinflation or auto PEEP

30
Q

Intermittent Mandatory Ventilation (IMV)

A

Vent delivers periodic breaths however spontaneous breaths are allowed between ventilator delivered breaths

31
Q

Intermittent Mandatory Ventilation (IMV) Indications

A

reduce risk of alkalosis and hyper inflation, COPD, Asthma,

32
Q

Intermittent Mandatory Ventilation (IMV) Settings

A

RR, TV, PEEP, FiO2

33
Q

Intermittent Mandatory Ventilation (IMV) adverse effects

A

Large work of breathing and high pressures maybe needed to deliver the preset tidal volume

34
Q

Syncronized vs Asyncronized

A

SIMV are syncronized breaths with spontaneous breathing. IMV can cause breath stacking and a breath being delivered while the Pt tries to exhale.

35
Q

Pressure Control Ventilation (PCV)

A

Breathes are delivered at a certain pressure and rate with a variable TV.

36
Q

Pressure Control Ventilation (PCV) Indications

A

Reduce risk of barotrauma, Pneumothorax, ARDS

37
Q

Pressure Control Ventilation (PCV) Settings

A

RR, Pressure support

38
Q

Pressure Control Ventilation (PCV) adverse effects

A

Variable inflation volumes R/T changes in lung mechanics

Principles III (24 decks)

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