Mv

Question 1

Ventilation

Answer 1

Movement of 02 in and co2 out

Question 2

Inspiration

Answer 2

Contraction causes negative pressure, active process

Question 3

Expiration

Answer 3

Passive process, positive pressure causes recoil

Question 4

Tidal volume

Answer 4

Amount of air moved in and out in one breath

Question 5

Minute volume

Answer 5

Amount of air moved in a minute

Question 6

FRC

Answer 6

Functional residual capacity - the amount of air left at the end of expiration.

Question 7

Anatomical dead space

Answer 7

air not involved in gas exchange in upper airway and tubing

Question 8

Physiological dead space

Answer 8

Air not involved in gas exchange at the alveoli level. Ventilation but no perfusion

Question 9

Pip

Answer 9

Peak inspiratory pressure- the maximum pressure required to inflate the lungs. Determined by compliance and resistance in vol control

Question 10

Peep

Answer 10

Maintained positive pressure at the end of expiration

Question 11

Peep benefits

Answer 11

Increase FRC
Prevent airway collapse
Maximise alveoli recruitment
Increase surface for gas exchange

Question 12

Disadvantages of peep

Answer 12

Hyperinflation
Co2 retention
Impaired venous return
Decreased CO

Question 13

Ti

Answer 13

Inspiratory time: time for gas flow/gas exchange before expiration

Question 14

Compliance

Answer 14

• Extent to which lungs/thoracic cavity can be distended
• determined by elasticity
• high: min pressure required to expand the lungs
• low: max pressure “” “

Question 15

Resistance

Answer 15

Amount of pressure required to move gas

Smaller airway- > resistance

Question 16

Cmv and indications

Answer 16

Control mandatory ventilation:

• preset tv and f
• breaths are machine trigger, limited, and cycled

Full control and no real effort eg gbs

Question 17

Machine cycled mandatory breath

Answer 17

Mandatory- machine trigger limited and cycled

Question 18

Machine cycled assisted breadth

Answer 18

Assisted - triggered by pt, limited and cycled by ventilator

Question 19

Patient cycled supporter breath

Answer 19

A spont breath with added inspiratory pressure

Question 20

Spont breath

Answer 20

Pt performs all work of ventilation

Question 21

Volume control

Answer 21

Volume is constant pressure is variable

-depends on compliance and resistance

Question 22

Cmv disadvantages

Answer 22

No spont breaths

A synchrony and atrophy, muscle weakness

Question 23

Volume assist control a/c mode & indications

Answer 23

Set f and tv
Pt can trigger own breaths and is assisted with set tv

• heavily sedated pt
  Unstable resp drive or weak/fatigue

Question 24

A/c advantages and disadvantages

Answer 24

A-pt can control rate
Prevents muscle fatigue

D- asynchrony
Auto peep

Question 25

Simv

Answer 25

Preset tv or pressure Can initiate spont breaths between mandatory, synchronised Spont breaths assisted by ps Window of time

Question 26

Window of time

Answer 26

Delivers mandatory breaths with pts inspiratory effort

Question 27

simv vol Indications Advantages disadvantages

Answer 27

Normal resp drive, weaning ``` A-Improved synchrony Increased comfort Decreased breath stacking B-fixed flow variable pressure Constant despite compliance resistance ```

Question 28

Compliance

Answer 28

The stretch on the lungs The pressure required to explans lungs and thoracic cavity Increased compliance = deceased elasticity (emphysema)

Question 29

Resistance

Answer 29

The amount of pressure required to move gas. | Degree of inhibition to gas flow

Question 30

Pressure control ventilation A and d

Answer 30

Pressure constant vol variable Volume dependant on patients compliance and resistance ``` A-good at opening airways Good pt vent synchrony Better gas flow and distribution D-no guaranteed volumes More haemodynsmic effects ```

Question 31

PSV

Answer 31

Pressure support ventilation Spontaneous mode Preset pressure achieved when pt inspires Volumes variable - effort, c, r

Question 32

Auto flow

Answer 32

Regulates inspiratory pressure and flow Delivers volume at lowest possible pressure reducing airway pressure

Question 33

Peep Pro and con

Answer 33

-increase Frc -> surface area and gas exchange Prevent alveoli collapse < airway resistance < wob < cyclic atelectrauma < l) vent after load Con: Haemodynsmic compromise Barotrauma from over distension Gas trapping and hyperinflation > icp

Question 34

Lung protective strategies

Answer 34

< tv < pplat 30 Check peep

Question 35

Volutrauma

Answer 35

Hyperinflation and shearing

Question 36

Barotrauma

Answer 36

Alveoli rupture | Pnumo

Question 37

BiotraumA

Answer 37

Release Inflam mediators