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Cardio Pulm > Mechanical Ventilators > Flashcards

Mechanical Ventilators Flashcards

1
Q

Purpose of Ventilator

A
  • decrease WOB
  • provide ventilation (not respiration)
  • maintain positive pressure
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2
Q

Mechanical Ventilator

A
  • process by which ventilation is maintained by an artificial or extrinsic means
  • machine used to force gas into lungs
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3
Q

Indications of ventilator use

A
  • inability to spontaneously ventilate

- disorder of gas exchange (unable to get O2 in or CO2 out)

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4
Q

Negative Pressure Ventilator

A
  • Iron Lung

- change in pressure in caase around chest to increase/decrease intrathoracic pressure to ventilate patient

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5
Q

Pressure Support Ventilation

A
  • pt must have adequate spontaneous effort

- provide preset amount of pressure during spontaneous effort to support pt efforts

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6
Q

Acute/impending respiratory failure

A

-pH 50mmHg

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7
Q

Types of Ventilators

A
  • negative pressure (iron lung)

- positive pressure

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8
Q

Positive Pressure Ventilator

A
  • blows air into lungs

- affected by compliance and resistance

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9
Q

Volume-Cycled ventilation

A

ends inspiration after a preset tidal volume has been delivered

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10
Q

3 types of positive pressure ventilation

A
  • volume-cycled
  • time-cycled
  • flow-cycled
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11
Q

Time-cycled ventilation

A

-ends inspiration after preset time has elapsed

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12
Q

Flow-Cycled

A

-ends inspiration when a preset flow rate is obtained

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13
Q

CPAP

A
  • applies continuous positive pressure during inspiration and expiration to a spontaneously breathing person
  • pressure prevents alveolar collapse, increased fuctional/residual capacity and oxygenation
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14
Q

Indications for CPAP

A
  • atelectasis

- sleep apnea

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15
Q

Advantages vs Disadvantages of CPAP

A

ADV-maintain respiratory strenth, used to wean from partial vent support

DIS-possible compromise to CO

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16
Q

Advantages vs Disadvantages of SIMV

A

ADV: to wan pts from vent, less likely to hypervent, CO less compromised

DIS: utilize demand valve that opens and allows airflow in response to certain neg pressures

17
Q

Assist Control Ventilation

A
  • preset rate and tidal volume programmed, which are delivered in absence of spontaneous effort
  • in response to effort, will assist pt’s efforts by delivering the tidal volume
18
Q

Indications of Assist Control Ventilation

A

pt with respiratory Mm fatigue, pulm edema or pneumonia

19
Q

Advantages vs Disadvantages of Assist Control Vent

A

ADV: pt may participate in vent

DIS: possibly hyperventilate

20
Q

Advantages vs Disadvantages of Pressure Support Ventilation

A

ADV: incr tidal volume to decr WOB & aids in weaning

DIS: difficult to ensure alveolar vent; no air given in absence of voluntary effort; increase tidal volume & decr RR

21
Q

BiPAP

A
  • similar to CPAP but gives different levels of pressure during inhale and exhale
  • help deliver more air to lungs
  • used for same problems as CPAP
22
Q

Ventilator Parameters

A
  • tidal volume
  • RR
  • FiO2
  • PEEP
  • PIP
23
Q

PIP

A
  • peak inspiratory pressure
  • how much force is needed to get air into lungs
  • if have restrictive or intubated=need greater amount
  • trauma risk: barotrauma
24
Q

High Pressure Alarm

A
  • alarms when PIP exceeds preset limit
  • indicates obstruction in tracheal tube or pt coughing/being agitated
  • may indicate worsening condition
25
Q

Low PEEP/CPAP alarm

A

-when preset PEEP or CPAP not maintained

26
Q

Low exhaled volume alarm

A
  • when exhale volume is < tidal volume

- indicates pt disconnected from tracheal tube or leak in cuff around tube

27
Q

6 Alarms

A
  • high/low pressure alarms
  • low PEEP/CPAP alarm
  • High/low exhaled volume alarm
  • apnea alarm
28
Q

Low pressure alarm

A
  • when tidal volume uses pressure below average PIP

- indicates leak in system

29
Q

High Exhaled Volume Alarm

A
  • pt getting more than preset minute ventilation

- if pt incr RR or agitated

30
Q

Apnea Alarm

A
  • when no air movement detected for period of time
  • indicates system failure or nonexistent O2 supply
  • initiate emergency procedures ASAP
31
Q

factors affecting weaning

A
  • ABGs
  • PFTs
  • Presence of Contraindications
32
Q

Weaning Complications

A
  • Atelectasis
  • Aspiration
  • Hypoxemia
33
Q

Signs of respiratory distress during mechanical vent

A
  • increased SCM contraction
  • recession of suprasternal and supraclavicular spaces and intercostal spaces
  • paradoxical motion of abdomen
  • diaphoresis
  • nasal flaring
  • tachycardia
  • tachypnea
  • cyanosis
34
Q

Contraindications to weaning

A
  • Required PEEP >5cm H20
  • if FIO2 >0.4
  • Unable to generate negative inspiratory pressure >/= 20 mmHg
35
Q

5 modes of ventilation

A
  • assist-control ventilation
  • synchronized intermittent mandatory vent (SIMV)
  • Pressure support vent
  • CPAP
  • BiPAP
36
Q

SIMV

A
  • programmed to deliver preset tidal volume and frequency
  • if pt fails to initiate, will deliver tidal volume and rate
  • if pt initiates, tidal volume depends on muscular effort by pt
37
Q

PEEP

A
  • positive end expiratory pressure
  • used to maintain open airways
  • increased PEEP=worse the pt is
38
Q

monitoring needs

for weaning

A
  • ABGs
  • Vitals
  • S/Sx respiratory distress

Cardio Pulm (27 decks)

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