Mechanical ventilation PE summary

Question 1

What are indications of ventilation ?

Answer 1

Apnoea
Acute ventilatory failure
Impending acute ventilatory failure
Severe oxygenation deficit

Question 2

How dis indications for ventilation manifest ?
IE - Clinically ? Bloodgas ?

Answer 2

Pa02- < 8 kPa 80mmHg and or Sa02 < 90% despite 40% O2 mask / mask CPAP?
Rising PCO2 or rising sufficiently to cause resp acidosis pH < 7.3
Resp rate > 40 /min
Vital capacity <15ml/kg or decreasing
MIP < 20 cmH20
MEP <30 cm H20

GCS 8 LESS and inability to protect airway

Question 3

Failure of oxygenation Type 1 Resp failure
Def?
Parameters
Causes ?

Answer 3

PaO2 < 10 .6 kPa or 80 mm Hg

Ventilation perfusion imbalance
Shunt
Diffusion defecit
Venous desat in the presence of above 3
Inadequate Fi02

Question 4

Failure of ventilation ? Type 2 failure
Def?
Parameters?
Causes ?

Answer 4

Acute rise PC02 or PaCO2 > 6 KPA or 45 mmHg

Reduced MV
Dead space ventilation
Increased CO2 production

Question 5

Name and define control types ?

Answer 5

p 4

Question 6

Name advantages and disadvantages of pressure vs volume control?

Answer 6

P5

Question 7

Describe the following modes ?
Pressure or volume assist control
Volume SIMV with pressure support
Pressure SIMV with pressure suppport
Pressure support ventilation
Bipap
CPAP

Answer 7

p 7

Question 8

Name first step in setting up vent
What mode is best in what situation ?

Answer 8

P8

Question 9

Def lung protective ventilation?
And reasoning behind it
Indications?

Answer 9

Tidal volume : 6-8 ml/kg
Permissive hypercapnia
Limit plat pressure 30 cmH20
RR higher than normal
FiO2 below 0.6
Peep 5-10 cmh20

Question 10

What would be ideal pressure support setting ?

Answer 10

8-10 cmm H20

Question 11

What would be ideal flow setting ?
Ideal IE
Trigger def?

Answer 11

40-60 L/min

Question 12

Def and name 4 effects of peep?

Answer 12

P 10
Gas exchange
Pulmonary mechanics
Cardiovascular effects
Intracranial pressure

Question 13

Def intrinsic peep?
Causes ?
Approaches to decrease intrinsic peep?

Answer 13

p12

Question 14

Give 12 adverse effects of MV ?

Answer 14

p14

Question 15

Def SBT?
Criteria SBT?
What to do next ?
What to do if criteria not met?
What are signs of failure of weaning or SBT failure ?

Answer 15

Trail to evaluate if a patient can be successfully weaned .

1.Oxygenation index >200 ph > 7.25
RR <35 PEEP <5 FiO2 <40
2. Adequate cough MIP 20mmHg
3. No vasopressors
4. No condition wich caused intubation

1. pSUP 10cmH20 30 fI 02 40
   Calculate RR/vT rAPID SHALLWO BREATHING INDEX
   < 105
   Then extubate if NPO 4 hours
2. Signs of failure
   RR , drop Sats
   BP drops