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Principles in Practice > Modes of Ventilation > Flashcards

Modes of Ventilation Flashcards

1
Q

Difference between BiPaP and CPAP

A
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2
Q

Indications for CPAP

A

patients without resp failure

*sleep apnea

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3
Q

Indications for Bipap

A

Patients with impending or existing respiratory failure

*bridge to mv

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4
Q

What does IPAP improve?

A
  • improve tidal volume
    • thus decreasing CO2
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5
Q

What does EPAP improve?

A
  • improve FRC
  • Helps recruit more alveoli thus increasing O2,may reduce work of breathing associated with autopeep
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6
Q

Indications for N/V

A
  • Restrictive disease
    • Pregnancy
    • Neuromuscular disease
    • Obesity
  • Obstructive Disease
    • COPD
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7
Q

N/V not indicated

A
  • Asthma
  • Pneumonia
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8
Q

N/V SETUP/ SETTINGS

CHART

A
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9
Q

I:E ratio

COPD

A

1:2 TO 1:3

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10
Q

I:E RATIO

OHS, NM & CWD

A

1:1

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11
Q

INSPIRATORY VOLUME

COPD

OHS, NM, & CWD

A

COPD: 0.8 - 1.2s

OHS, NM, & CWD: 1.2 - 1.5S

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12
Q

Four phases of the ventilatory cycle

A
  • Inspiration
  • Inspiration to expiration
  • Expiration
  • Expiration to inspiration
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13
Q

Trigger

A

FLOW VS PRESSURE

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14
Q

LIMIT

A

Determines the size of the breath

* normally associated with volume-controlled ventilation

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15
Q

CYCLE

A

Determines what actually ends the breath

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16
Q

PSV

A

FLOW IS CYCLE

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17
Q

VCV and PCV

A

TIME IS CYCLE

18
Q

PCV

A
  • less barotrauma
  • esp. with pediatrics
19
Q

Volume cycled; volume-controlled

A
  • preset volume
  • DOES NOT ELIMINATE THE WORK OF BREATHING
20
Q

Assist- Control Ventilation

A
  • if not breathing go to CMV
  • if breathing too rapidly go to SIMV
21
Q

What is this?

A

assisted breath

22
Q

What does SIMV allow a patient to do?

A

Dr. Massie often put LMA with PS

if they are not breathing after the induction meds she puts her patient on SIMV OR PC

one they go above that pressure she changes them

  • BETTER THAN CMV
23
Q

How is the patient’s compliance tested?

A

most sensitive is when we bag the patient

24
Q

if lung compliance is lower what happens to pressure?

A

compliance is lower = higher pressure

25
Q

Change in Pressure/change in volume =

A

compliance

26
Q

What is compliance?

A

measure of distensibility

27
Q

how is compliance expressed?

A

change in volume for given change in pressure

Vt (Paw-Peep)

28
Q

What is normal compliance?

What is compliance in ARDS?

A

70 - 100 ml/cm H20

<40-50 ml/cm H2O

29
Q

What is FeO2?

A

what the patient is expiring and it should equilibrate

with your FiO2

* we are always trying to reach equilibrium

30
Q

What is normal lung compliance?

A

5-7 ml/kg with IBW

31
Q

If your patient is obese what will be your TV?

A

lowered end of 5-7 ml/kg

so ill use the 5 ml because of abnormal lung compliance (ARDS pulmonarycontusion)

32
Q

what is the normal MV?

A

5-10 L/ M

MV= TV*RR

33
Q

SENSITIVY SLIDE

A

also known as trigger and percent trigger

34
Q

Inspiratory flow rate is..

what causes barotrauma?

A
  • NOT GAS FLOW
  • >75
35
Q

Why do we add PEEP?

A

GOAL: To reach the best arterial oxygenation with the least decrease in cardiac output and maintenance of acceptable airway pressure

36
Q

How do we assess PEEP?

A

we are looking for

OPTIMAL PEEP - point of maximal alveolar recruitment (MAR)

  • Increase PEEP to point of lung inflation at which compliance decreases
    • observe airway pressure with each increase in PEEP
    • PIP should rise only by the amount of PEEP dialed in; when PIP rises more than PEEP, alveoli overdistended and point of MAR exceeded
37
Q

What are SE of PEEP?

A
  • Barotrauma
  • Decrease in CO
  • Incorrect filling pressures
    • If PEEP applied subtract 1/2 of the PEEP over 5 from PCWP
38
Q
A
39
Q

How to increase MEAN ARTERIAL PRESSURE?

A
  1. Increase respiratory flow rate
  2. Increase peak inspiratory pressure
  3. Increase in inspiratory time
  4. Increase in PEEP
40
Q

Pressure Support Ventilation

slide*

A
41
Q

Pressure- Controlled/ Limited Ventilation

A
  • If you have gradually increasing Peak Inspiratory Flow switch to Pressure Controlled to see how it will decrease it
  • Dr. Massie use this on her LMA
    • good for neonatal
    • good for NMD with normal lungs

Principles in Practice (19 decks)

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