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RT, Mechanical Ventilation (III Semestre) > Modes Of Ventilation Chap 5 > Flashcards

Modes Of Ventilation Chap 5 Flashcards

1
Q

The mode that we set our patient will describe how…

A

We ventilate our patient

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2
Q

What variable initiate Ventilation?

A

The Trigger variable

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3
Q

What variable stop ventilation?

A

The Cycle Variable

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4
Q

What will happen to a patient that Inspiratory time is too slow? why?

A

It will increase WOB, because he will try to pull air into the lungs**.

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5
Q

The most common side effects of opioids include:

A
  • Respiratory Depression
  • Ileus, hypotension
  • Hallucinations
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6
Q

Once the need for mechanical ventilation has been stablished, the clinitian must select:

A
  • Type of Ventilation
  • Ventilation mode
  • Breath type
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7
Q

What type of ventilation should be more appropiate for a patient with Amyotrophic Lateral Sclerosis?

A

Noninvasive Ventilation (Because the problem is not the airway, here we have a muscle atrophy and nerves)

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8
Q

TRUE or FALSE

A patient can be connected to a positive presure ventilation using either positive pressure mask or an artificial ariway?

A

TRUE,

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9
Q

What are the two methos of providing Noninvasive pressure ventilation?

A
  1. CPAP
  2. NIV

Both methods most commoly administrated via nasal facial mask

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10
Q

TRUE or FALSE

Air trapping in patient with COPD and acute asthma patients can lead to and increase in FRC while on CPAP treatment?

A

TRUE,

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11
Q

Externally applied CPAP can reduced WOB?

A

TRUE, Mask CPAP set at 80% to 90% of the measured auto PEEP reduces diapragmatic work and dyspnea, improve gas exchange, and does not worsen hyperventilation.

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12
Q

What treatment would you use to treat a Chronic Bronchitis patient who develops a Pnemonia?

A

Bilevel PAP, is the method most often use to treat acute on Chronic Respiratory Failure.

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13
Q

Finding suggest that NIV can reduce the need for intubation in how much percentage?

A

60% to 75% of the patients

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14
Q
  • Chronic Bronchitis
  • Chest Wall Deformities
  • Neuromuscular Disorders
  • Central Alveolar Hypoventilation
  • COPD

Are some Disorder manage by NPPV?

A

YES

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15
Q

Advantages of NPPV

A
  • Avoids complications associated with artificial airway
  • Provide flexibility in initiating and removal mechanical ventilation
  • Reduces requirment for heavy sedation
  • Preserve airway defense, speach, and swallowing mechanisims
  • Reduces need for invasive monitoring.
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16
Q

Disadvantages of NPPV

A
  • Can cause Gastric Distension
  • Eye Irritation
  • Fasial Pain
  • Dry Nose
  • Discomfort
  • Claustrophia
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17
Q

What mode might include Full Ventilatory Support

A
  • Fully Controlled mode
  • A/C VC
  • A/C PC
  • SIMV (VC, PC)
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18
Q

Control Variable

/

A

Is the variable that is set by the clinitian

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19
Q

Limit Variable:

A

Is the maximun value parameter can attain, but does not end inspiration.

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20
Q

What are the most commons Variables:

A
  • Pressure
  • Flow
  • Time
  • Volume
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21
Q

TRUE or FALSE

Breaths types is the way how we differentiate modes?

A

TRUE, this include:

  • Controlled or Mandatory
  • Assisted
  • Spontaneous
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22
Q

Controlled or mandatory Mode:

A

Here the ventilator controlled:

  • Timing
  • Tidal Volume
  • Inspiratory Pressure

It is preset by the clinitian and it works automatically, patient has no participation on this mode.

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23
Q

Assisted Mode

A

In Assited Breath, all or part of the breath is generated by the ventilator. which does part of the WOB of the patient. Here, just as Mandatory Mode the clinitian set the ventilator but, is the patient who triggers the breaths.

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24
Q

Spontaneous Breaths Mode

A
  • It is patient trigger or Time if PVS is added.
  • Cycle by Patient or Flow if PSV was add it.
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25
Q

This is what type of Breathing Graph?

A

Spontaneous Breathing

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26
Q

In Mandatory Controlled mode, if pressure is preset this is called?

A

Pressure Targeted

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27
Q

In Mandatory Controlled Mode, If Volume is preset, this is called?

A

Volume Targeted

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28
Q

How CPAP works?

A

It applied positive pressure to the airways during Spontaneously Breathing.

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29
Q

CPAP indications:

A
  • Intrapulmonary Shunting
  • Refractory Hypoxemia
  • Decrease FRC and Lung Compliance
  • Loss of normal expiratory resistance caused by bypassed Glottis.
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30
Q

Goals of CPAP:

A
  • Increase FRC
  • Increase surface for gas exchange
  • ↑ Oxygenation
  • Compensation for the loss of normal expiratory resistance caused by bypassed Glottis.
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31
Q

Complication of CPAP

A
  • ↓ Cardiac Output
  • Barotrauma (trauma caused by ↑ P)
  • ↑ ICP
  • ↓ Renal blood Flow
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32
Q

Pressure Support Ventilation (PSV), only work with:

  • a. Controlled/Mandatory Mode
  • b. Assist Mode
  • c. Spontaneous Mode
A

c. Spontaneous Breathing Mode

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33
Q

PSV is what type of mode?

A

Assist mode

On PSV mode the clinitian sets: Inspiratory Pressure, PEEP, Flow cycle criteria, and Sensitibity, while the patient stablished Rate, Inspiratory Flow, and Inspiratory Time (Ti)

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34
Q

This is what type of Graph?

A
  • This is an Spontaneous Breath Graph with pressure support add it.*
  • (PSV)*
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35
Q

Indication for PSV?

A
  • Over come ET resistance
  • Facilitate weaning
  • ↓ WOB
  • ↑ Sponataneous Vt
  • Reverse Tachypnea.
36
Q

Complications of PSV

A
  • ↓ Cardiac Output
  • ↑ ICP
  • ↓ urine Output
  • Barotrauma
37
Q

IPAP is different from clasical Bilevel PAP, and is genarally intented for patient with:

A

ARDS

38
Q

In BIPAP the clinitian sets two pressures:

A
  • Inspiratory Airway Pressure (IPAP)
  • Expiratory Airway Pressure (EPAP)
39
Q

TRUE or FALSE

In BIPAP, Inspiratory Airway Pressure is Patient triggers, but can also be Time triggered. It can be Flow or Time cycle.

A

True

40
Q

Bi-level Positive Airway Pressure (BIPAP), IPAP helps to:

A
  • Improve alvelar Ventilation
  • Normalize PaCO2
  • Reduce WOB
  • Reverse Tachypnea
41
Q

EPAP helps to:

A
  • ↑ FRC
  • ↑ Oxygenation
42
Q

BIPAP Indications:

A
  • CHF
  • Prevent Intubation
  • Support Patients with Chronic Ventilatory Failure
  • Neuromuscular Desease
  • Noctirnal Hypoventilation
43
Q

BIPAP initial setting:

A
  • IPAP 10 cm H2O
  • EPAP 5 cm H2O
44
Q

Complication of BIPAP

A
  • ↓ Venous Return
  • Barotrauma
  • ↑ ICP
  • ↓ Urine Ouput
45
Q

Control Mode the Ventilator Delivers:

A
  • Tidal Volume
  • Inspiratory Pressure and Time
  • RR

Here on this Mode Patient can not Trigger the ventilator

46
Q

What is the difference between BIPAP and CPAP

A

BIPAP is noninvasive Ventilation Support,

CPAP can be Invasive and Noninvasive ventilation Support

47
Q

Indication for Controlled Mode:

A
  • Patient tht is Dyssynchronous with the ventilator
  • Tetanus or seizure activity that interrupts the delivery of mechanical ventilation
  • Complete rest of the patient
  • Patient with crushing Chest
48
Q

Complication of Controlled Mode:

A
  • ↓ Cardiac Output
  • Barotrauma
  • ↑ ICP
  • ↓ Urine Output
  • Potential for Hypoxia and Apnea if disconnect occurs.
49
Q

What Ventilator mode can Provide Spontaneous Breaths?

A
  • Spontaneous Breathing
  • CPAP
  • PSV
50
Q

What are the 3 basic used function of PSV?

A
  • Reduce WOB on Spontaneous Breathing
  • Reduce WOB on CPAP
  • Provide full ventilatory support on assist mode
51
Q

What we do in order to adjust volume?

A

We ↑ or ↓ pressure

  • ↑ pressure = ↑ Volume
  • ↓pressure = ↓ Volume
52
Q

TRUE or FALSE

PCV mode ventilation:

  • During the inspiratory phase the machine reaches a pre-set pressure and mantains it for the duration of inspiration
  • Helps to reduce peack airway pressure & mean airway pressure
A

TRUE

53
Q

Indication for PCV?

A

Severe Restrictive Lung Disease, Specially ARDS

54
Q

Complication of PCV

A
  • Variable Tidal Volume
  • Hypopnea
  • Hypoventilation
55
Q

What Type of breath we see in A/C VC mode?

A
  • Mandatory
  • Assisted
56
Q

What Breath type we see on SIMV mode?

A
  • Mandatory
  • Assisted
  • Spontaneous
57
Q

What type of Breath we see on CPAP/Spontaneous mode?

A

Spontaneous only, here the patient must breath normally to trigger the ventilator

58
Q

TRUE or FALSE

Controlled Mode is TIME triggerd, and the patinet makes not Spontaneous Breathing!!

A

TRUE, On this mode patient is not allowed to breath spontaneously, the clinitian sets everything.

59
Q

Patients who are obtunded because of drugs, cerebral malfunction, spinal cord or phrenetic nerve injury, or motor nerve paralysis, may not be able to make voluntary effort. Under these conditions, what type on mode ventilation would you suggest for these type of patients?

A

Controlled mode

60
Q

Limit Variable is?

A

A variable that Limits the value of Pressure, Volume, Flow or Time during inspiration.

61
Q

What Triggers A/C VC?

A
  • Time
  • Patient
62
Q

What Cycle Volume Control?

A

Volume

63
Q

What Cycle Pressure Control (PC)

A

TIME

64
Q

What Triggers Assist Control (AC)?

A

Time and Patient

65
Q

What Cycle AC-VC?

A

Volume

66
Q

What Cycle AC-PC?

A

Time

67
Q

What type of Breath can be given with SIMV mode?

A
  • Mandatory
  • Assist
  • Spontaneous
68
Q

What Cycle SIMV, Spontaneous Breath mode?

A
  • With PSV, Flow does it.
  • Whithout PSV, Patient Cycle it.
69
Q

What cycle SIMV, Mandatory and Assist breath?

A
  • Volume (VC)
  • Time (PC)
70
Q

What triggers SIMV?

A
  • Time
  • Patient
71
Q

What Triggers Spontaneous Breaths?

A

The Patient

72
Q

What Cycle Spontaneous Breaths?

A
  • PATIENT, without PVS
  • FLOW, with PSV
73
Q

What will happen to PaCO2, if we increase VE?

A

PaCO2 will decrease.

74
Q

What will happen to PaCO2, if we decrease VE?

A

PaCO2 will increase

75
Q

In which mode, PSV functios?

A

CPAP/Spontaneous, SIMV and, in any mode that have Spontaneous mode

76
Q

When PC is preset, what will varies?

A

Volume will varies, because pressure is already preset.

77
Q

If VC is preset, what will varies?

A

Pressure will varies, because volume is already preset.

78
Q

Define Mandatory Breath?

A

It is a time trigger mode, Cycle by TIME when is on PC mode, or VOLUME when is on VC mode

79
Q

Difine Assist Breath?

A

It is TIME, PATIENT trigger mode, Cycle it by TIME when is on PC, or VOLUME when is on VC mode.

80
Q

Define Spontaneous Breath?

A

Is a PATIENT trigger mode, cycle it by the PATIENT if is without PSV. or FLOW if is with PSV.

81
Q

If a patient IBW is 80Kg, what will be his Tidal Volume?

A

6x80Kg = 480 ml

480ml will be his VT

82
Q

What type of breath is this?

A

Time Mandatory Breaths

83
Q

What mode is this?

A

Assist/Control

84
Q

What type of Breath mode is this?

A

Spontaneous Breath with PSV added it.

85
Q

This is what type of Breath?

A

Mandatory Breath triggered by Time

86
Q

This is what type of Breath?

A

Spontaneous and Assisted

87
Q
A

RT, Mechanical Ventilation (III Semestre) (7 decks)

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