Pt getting better strats (Mod 4) Flashcards
Why should we titrate to the patients WOB if they’re getting better?
- To promote patient/ventilator synchrony
- Support muscles of ventilation (based on patient/vent work)
What is tube compensation?
When the ventilator nullifies the resistance imposed by the airway via ETT
- similar to PS, Inspired pressure is used to compensate for imposed WOB
How are time constants affected by tube compensation?
TC varies the pressure depending on the tube size and Pt inspiratory flow
How is Tube Compensation calculated?
Ptrachea = (Paw - Ktube) x Flow^2
What are benefits of tube compensation?
Increase patient comfort over Psupport
- could indicate readiness for extubation
- Reduce risk of air trapping caused by expiratory resistance (some allow insp and exp comp)
What settings are required for tube compensation? (ATC mode)
- Type of airway (ETT vs Trach)
- Size of airway
- % compensation (0-100)
- Inspiratory and expiratory or inspiratory or expiratory only (set up configuration)
What is Tube compensation mode on the Evita?
Automatic tube compensation (ATC)
What is Tube compensation mode on the Hamilton G5?
Tube Resistance Compensation (TRC)
What is Tube compensation mode on the GE?
Airway Resistance Compensation (ARC)
What is Tube compensation mode on the PB 840/980?
Tube compensation (TC)
What does Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive) do?
A mode that guarantees a min MV even though a Pts spontaneous ventilation may change.
In Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive), what happens if the patient maintains a MV above the set MV?
Then the mode functions like CSV-PS
- all breaths are supported breaths
In Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive), what happens if the patient MV falls below the set MV?
Mandatory breaths will be delivered (at the set Vt) to makes the total MV = set MV
- Only the M breaths required to return the Pts MV to the set MV
How does Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive) differ from SIMV?
SIMV will always provide the set number of mechanical breaths a minute, regardless of the patients spontaneous MV
what does the number of M breaths per minute depend on in Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive)?
How much the patient is breathing own their own
- assisted breaths are technically possible if the pt made an inspiratory effort during the window
What happens in Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive) if the patient becomes totally apneic?
They will get mandatory breaths at the set rate
What breath types are delivered in Mandatory Minute ventilation (VC-IMV or PC-IMV adaptive)
All breath types (M,A,S), but usually only mandatory and spontaneous supported are seen.