Methods to Improve Ventilation

Question 0

What does a paco2 value greater than 45 mmHg indicate?

Answer 0

Hypoventilation

Question 1

What two values of an ABG are used to evaluate ventilation?

Answer 1

Ph and paco2

Question 2

What factors can alter paco2 during mechanical ventilation?

Answer 2

Total ventilation
Dead space
Co2 production

Question 3

For COPD patients, what is their normal paco2?

Answer 3

50 torr or their last hospital discharge

Question 4

What are the causes of acute respiratory acidosis?

Answer 4

• parenchyma lung problems
• airway disease
• pleural abnormalities
• chest wall abnormalities
• neuromuscular disorders
• cns problems

Question 5

How do you change minute ventilation?

Answer 5

Adjust tv or frequency

Question 7

What should you do to correct paco2 abnormalities in volume ventilation for respiratory acidosis?

Answer 7

Increase the vt or frequency (check vt is appropriate first before changing frequency)

Question 8

Regardless of the mode, what is the main thing you should do to correct a paco2 abnormality in respiratory acidosis?

Answer 8

Increase minute ventilation to lower paco2

Question 10

What is the equation in volume ventilation for determining the proper minute ventilation for the desired paco2?

Answer 10

(Desired paco2) x (desired VE) = (current paco2) x (current VE)

Question 11

For the previous equation, what can you substitute desired/current minute ventilation with to determine the proper tidal volume or rate based on the paco2 you want to achieve?

Answer 11

Desired/current tidal volume or rate, depending on which you are trying to change

Question 12

In respiratory acidosis paco2 abnormalities, what should you keep the target vt and plateau pressure at?

Answer 12

Target vt- 5-12ml/kg of ibw

Plateau pressure- <30 cm/h2o

Question 13

What should you do if you need to increase vt during pressure ventilation of respiratory acidosis?

Answer 13

• optimize inspiratory time

- increase pressure

Question 14

What is the equation for finding desired pressure in pressure ventilation of respiratory acidosis?

Answer 14

Cstat

Question 15

What should you do if the vt is fine in pressure ventilation of respiratory acidosis?

Answer 15

Increase the frequency

Question 16

REMEMBER FOR RESPIRATORY ACIDOSIS

Answer 16

All equations are based on vco2 and VD remaining constant

Question 17

What are the 5 additional ways you can treat respiratory acidosis?

Answer 17

• assess nutritional support
• reconditioning of respiratory muscles
• PSV
• use largest et tube possible
• bronchodilators

Question 18

What are the common causes of respiratory alkalosis paco2 abnormalities?

Answer 18

• hypoxemia with comp hyperventilation
• parenchymal lung disease
• medications
• CMV
• cns
• anxiety
• metabolic acidosis

Question 19

What should you do to correct paco2 abnormalities in pressure ventilation for respiratory alkalosis?

Answer 19

Decrease the pressure or frequency (check vt first before adjusting pressure)

Question 20

What should you do to correct paco2 abnormalities in volume ventilation for respiratory alkalosis if vt is appropriate?

Answer 20

Decrease the frequency

Question 23

In pressure ventilation for respiratory alkalosis, what would you more than likely decrease?

Answer 23

The rate (don’t usually decrease vt)