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Kendigs > Principles of Mech Vent > Flashcards

Principles of Mech Vent Flashcards

1
Q

3 elements in Vt delivery

A

Breath is triggered
Gas flow
Ventilator cycles off

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2
Q

in this setting,
volume is delivered equally each fraction of inspiratory time

constant FLOW RATE

A

volume triggered

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3
Q

INspiratory gas flow in pressure targeted setting depends on _______ pressure

A

airway pressure at the trachea and alveoli

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4
Q

Expiratory pressure generator

A

PEEP

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5
Q

In this type of flow setting, Vt is predetermined and fixed ( independent of peep)

A

Volume controlled

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6
Q

aside from tidal volume, what else is fixed in volume controlled setting

A

Inspiratory time

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7
Q

what is the FLOWN wave pattern in volume control

A

Square wave

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8
Q

Advantage of pressure control

A

Increased MAP
Increases alveolar recruitment duration
Protect agains barotrauma

Allows for a significant leak

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9
Q

Advantage of volume control

A

Stable minute ventilation
Initial flow rate is LOWER
(If airway resistance is HIGH)

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10
Q

Diasdvanate of PC

A

Uncontrolled volume may result to volutrauma
Tidal volume depends on respiratory compliance

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11
Q

In PC, the flow (volume) of gas, depends on the pressure difference of ______,
And DIMINISHES over time —> “Decelerating ramp flow”

A

Gas source (ventilator) and
Gas destination (alveoli)

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12
Q

What changes the flow or can alter the flow in PC

A

Change in compliance, resistance, patient effort
*not the pressure

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13
Q

Initiation and termination of a PC breath depend on _______

A

Timing (rate)
Duration of itime

*set on the vent

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14
Q

pressure and principles of flow are the same as PC bur the initiation of breath needs to be triggered by inspiratory effort of the patient

A

Pressure support

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15
Q

In PS, termination of inspiration happens when insp flow rate falls

A

20-30% of the initial flow rate

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16
Q

vent provides all the work

A

CMV

17
Q

breath initiated by the patient and vent completes the breath

with minimum (back up) breaths per minute

A

AC

weaning is difficult

18
Q

intermittent mandatory breaths based on the set minute vent

px can make their own breaths not altered

A

IMV

19
Q

better patient vent synchrony

A

SIMV

20
Q

High flow can deliver up to how many ml per min gas flow

A

8L/min in an infant
60 L/min large child

21
Q

peep of high flow

A

2-5

22
Q

Continuous distending pressure
small vts at a rapid rate

A

High frequency vent

23
Q

HFOV hz and bpm

A

600-900 bpm
10-15 Hz

24
Q

major use of HFOV

A

lung recruitment

25
Q

HFOV vs conventional

A

Co2 clearance despite small VTs less than physiologic dead space

CO2 removal INCREASED by DECREASING the frequency (increased VT to develop, inc co2 clearance)

26
Q

when is PPV hemodynamically beneficial?

A

positive pressure ventilation decreases wall stress hence lower value of intraventricular pressure

MVR
(more sensitive to afterload)

27
Q

effect of PPV on cardiogenic pulmonary edema

A

edema rate is slowed (lower venous return to the thorax)

cardiac output is increased

28
Q

commonest indication for MV

A

GA

29
Q

Bronchiolitis MV strategies

A

balancing peep
VT target 6-8 ml/kg
RR titrated

30
Q

problem encountered in bronchiolitis

A

dynamic hyperinflation

31
Q

Goal of mv in PPHN

A

oxygenation
recruit lung
Co2 clearingb
alleviate ph

32
Q

mechanism of mech vent in pphn

A

reduced R to left shunt

high fio2

LONGER Tinsp
lower PaCo2

33
Q

Mv for CHD
large left to right shunt
(elevated pulmo bflow)

A

adequate peep to mt frc
lower fio2
hypercapnia

34
Q

in low pulmo blood flow

A

hypercapnia
adjust peep and vt (to inc blood flow)
early extubation

Kendigs (24 decks)

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