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CVPR 360 ECMO > Miscellaneous for Midterm exam > Flashcards

Miscellaneous for Midterm exam Flashcards

1
Q

What vent setting is used to fight atelectasis?

A

PEEP

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2
Q

Compliance formula =

A

Change in volume
_______________
Change in Pressure

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3
Q

ECMO pump is set on free mode, what does this mean?

A

The pump is not paying attention to anything.

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4
Q

ECMO pump is set on Stand Alone mode, what does this mean?

A

The pump is servoregulated by safety mechanisms / parameters.

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5
Q

IRV

A

Inspiratory Reserve Volume

Amount of air that you can still breathe in if you needed to.

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6
Q

TV

A

Tidal Volume = (6 - 8 mL/kg)

Normal volume in/out during a normal respiration.

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7
Q

ERV

A

Expiratory Reserve Volume

Amount of air that you can still breathe OUT if you needed to.

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8
Q

RV

A

Residual Volume

Amount of air you have left in the lungs after a maximal expiration. (Air not able to breathe out)

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9
Q

IC

A

Inspiratory Capacity

VT + IRV

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10
Q

FRC

A

Functional Recidual Capacity

RV + ERV

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11
Q

VC

A

Vital Capacity = Maximum amount of gas that we can expire after a maximal expiration.
IRV + VT + ERV

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12
Q

TLC

A

Total Lung Capacity

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13
Q

Mnemonic used to remember my lung volumes ?

A 
L
I
T
E
R
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14
Q

How could an increase in PEEP compromise ECMO function ?

A

↑ PEEP = ↑ Oxygenation, but also ↑ Intrathoracic pressure

which leads to ↑ pressure of the heart specially the RA which would therefore compromise VENOUS DARINAGE.

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15
Q

Vent Settings for an Adult ?

FiO2
PIP
PEEP
VT
R
A 
FiO2: 60%
PIP:   15
PEEP: 1 -3
VT:    6 - 8 
R:     12 - 15
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16
Q

Vent Settings for an Neonate ?

FiO2
PIP
PEEP
VT
R
A 
FiO2: 60%
PIP:   20
PEEP: 1 -3
VT:    8 - 10
R:     20
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17
Q

Blood flows through the hollow fibers of the dialyzer, and a cleansing fluid , known as a dialysate solution, flows in the opposite direction. This configuration maximizes the removal of wastes. Throughout this process, the waste molecules move from a higher concentration in the blood to a lower concentration in the dialysate.

A

CRRT

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18
Q

This type of CRRT removes fluid without the need for replacement fluids. This can help prevent or treat fluid overload in cases when waste products don’t need to be removed, or the pH levels don’t need to be corrected. This method doesn’t use a blood pump the way other systems do– it’s driven instead by the patients’ own blood pressure; Arterial to Venous. Apparently it doesn’t work well to clear BUN or creatinine. Karen the CVVH goddess says that it doesn’t get used much anymore.

A

Slow Continuous Ultrafiltration (SCUF)

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19
Q

This type of CRRT removes large volumes of fluids and waste from the patient. It then uses replacement fluids (also known as a substitution solution), which are devoid of toxins, to maintain electrolyte and acid base balance.

A

Continuous Venovenous Hemofiltration (CVVH)

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20
Q

Initially developed for the management of hemodynamically unstable patients with acute renal failure, It is now is also used for management of fluid overload and acid-base disturbances resulting from conditions such as acute pulmonary edema, congestive heart failure, septic shock, and oliguric states in which pharmacologic or parenteral nutrition therapy necessitates administration of large volumes of fluids.

A

Continuous arteriovenous hemofiltration

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21
Q

fluid (in the form of water molecules) can pass through the semipermeable filter membrane, and by applying a suction pump on the far side of the membrane, you can suck water out of the patient, through the filter, at apparently whatever rate you’d like. This is called “creating a transmembrane pressure gradient”

A

Hemofiltration AKA Ultrafiltrtation

22
Q

It’s an interesting thing about molecules – they’re adventurous. They want to go places. But – and they’re very serious about this - it’s really important for them to spread themselves around evenly; they want to travel with their friends, or not at all. If they see a place where they’re under-represented, over across yonder semi-permeable membrane for example, (Montana, maybe), well, off they’re gonna go, until there’s just as many over there across the border in Montana as there are over here in Idaho. Wyoming maybe. Nice, compulsive little ICU-personality molecules. “diffusion across a concentration gradient”. Of course the membrane has to have holes in it to let ‘em through, right? Just the right size holes too, ‘cause ya don’t wanna be losing your albumins and all, or your red cells.

This treatment can produce really enormous changes in the patient’s body over a pretty short time: they can pull off volume very quickly, change electrolyte and BUN/cr concentrations quickly – that kind of thing, and patients with hemodynamic problems just don’t like that very much.

A

Hemodyalisis

23
Q

What is the name of the port through which volume is removed from a hemoconcentrator?

A

Effluent Port

24
Q

pressure control mode of mechanical ventilation that utilizes an inverse ratio ventilation strategy. APRV is an applied continuous positive airway pressure (CPAP) that at a set timed interval releases the applied pressure.

A

APVR

25
Q

Name a potent selective pulmonary vasodilator ?

A

Nitric Oxide (NO)

26
Q

Physiological phenomenon in which pulmonary arteries constrict in the presence of hypoxia without hypercapnia, redirecting blood flow to alveoli with a higher oxygen content.
It is explained by the fact that constriction leads to redistribution of bloodflow to better-ventilated areas of the lung, which increases the total area involved in gaseous exchange.

This improves ventilation/perfusion ratio and arterial oxygenation, but is less helpful in the case of long-term whole-body hypoxia.

A

Hypoxic Pulmonary vasoconstriction

27
Q

Oxygen Index Formula =

A

(Mean Airway Pressure) (FiO2 / PaO2) (100)

28
Q

Oxygen Index > 25 but

A

ECMO

29
Q

MAS pts placed on ECMO survival rate ?

A

94%

30
Q

CHD in which the coronaries receive venous blood ?

A

Anomalous LCA

Patient should be placed on ECMO

31
Q

What were the two diagnosis in which neonate patients had the GREATEST survival rate ?

A

MAS 94%

RDS respiratory distress syndrome / HMD 84%

32
Q

What were the two diagnosis in which neonate patients had the WORST survival rate ?

A

Air Leak Syndrome 67%

CDH 59%

33
Q

Overall statistics for RESPIRATORY pediatric:
Weaned from ECMO?
Survived to DC or Txfr ?

A

Weaned from ECMO 62%

Survived to DC or Txfr 55%

34
Q

Overall statistics for CARDIAC pediatric:
Weaned from ECMO?
Survived to DC or Txfr ?

A

Weaned from ECMO 54%

Survived to DC or Txfr 40%

35
Q

What were the two diagnosis in which PEDIATRIC patients that had the GREATEST survival rate ?

A

Apiration 65%

Intrapulmonary Hemorrhage 62%

36
Q

What were the two diagnosis in which PEDIATRIC patients that had the WORST survival rate ?

A

Pneumocystis pneumonia 43%
Bacterial Pneumonia 50%
Other 51%

37
Q

Pneumocystis pneumonia (PCP) definition ?

A

is a form of pneumonia, caused by the yeast-like fungus

38
Q

Overall statistics for RESPIRATORY ADULT:
Weaned from ECMO?
Survived to DC or Txfr ?

A

Weaned from ECMO 54%

Survived to DC or Txfr 50%

39
Q

Overall statistics for CARDIAC ADULT:
Weaned from ECMO?
Survived to DC or Txfr ?

A

Weaned from ECMO 40%

Survived to DC or Txfr 32%

40
Q

What were the two diagnosis in which ADULT patients that had the WORST survival rate ?

A

Pre/Post Transplant 27%

MVR 0%

41
Q

What were the two diagnosis in which ADULT patients had the GREATESTT survival rate ?

A

Viral Pneumonia 65%

ARDS 59%

42
Q

What are the 2 Cardiac Pathologies with the BESTsurvival rate?

A

Cardiomyopathy 52%

Myocarditis 51%

43
Q

What are the 2 Cardiac Pathologies with the WORST survival rate?

A

Cardiac Surgery 40%

Cardiac Transplant 40%

44
Q

What is the CHD with the BEST survival rate ?

A

Anomalous LCA 66%

45
Q

What is the CHD with the WORST survival rate ?

A

HLHS 25%

46
Q

Vernix definition ?

A

Fuzzy hair that the fetus is covered in. If aspirated, Inflammatory process begins, wipes out surfactant.

Treat with Perfluorocarbon

47
Q

CDH is often associated with what?

Why?

A

PPHN

Secondary to hypoxemia caused by the hypoplastic lung

PaO2

48
Q

Ventilation problem that turns into a perfusion problem ?

A

RDS / HMD

49
Q

Better Bladder BB14

Tubing ID X OD
Volume
Pressure Port
Low Pressure Limit

A

Tubing ID X OD 1/4 X 3/8
Volume 25 ml
Pressure Port Female luer
Low Pressure Limit -250 mmHg

50
Q

Better Bladder BBB38

Tubing ID X OD
Volume
Pressure Port
Low Pressure Limit

A

Tubing ID X OD 3/8 7/16
Volume 110 mL
Pressure Port Female luer
Low Pressure Limit -250 mmHg

CVPR 360 ECMO (13 decks)

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