Pulmonary Flashcards
what is the clinical indicator of ventilation?
PaCO2
what is minute ventilation? What is the norm?
tidal volume x respiratory rate
normal: ~4L/minute
what is the normal ventilation/perfusion ratio?
0.8 ratio,
4L ventilation/min //
(over/divided by)
5L perfusion/minute (V/Q)
normal SvO2?
60-75%
What conditions shift the oxyhemoglobin-dissociation curve to the left?
Alkalosis (low H+)
Low PaCO2
Hypothermia
Low 2,3-DPG
left is alllllllkolosis
What conditions shift the oxyhemoglobin-dissociation curve to the right?
Acidosis (high H+)
High PaCO2
Fever
High 2,3-DPG
Pro and Con to oxyhemoglobin-dissociation curve shift to the left:
Good: higher SaO2
Con: tissues do not get needed O2 as readily
aLkaLosis, coLd, Low, bad for patient, SaO2 high but O2 stuck to Hgb
Pro and Con to oxyhemoglobin-dissociation curve shift to the right:
Good: tissues receive O2 more readily
Con: SaO2 is low
what is the treatments for carbon monoxide poisioning?
100% FiO2 until symptoms resolve and carboxyhemoglobin level is <10%
Hyperbaric O2 chamber if available, generally within 30 minutes
Normal for anion gap:
5-15 mEq/L
What peak flow rate (PFR) is severe?
50% (admit to hospital if <70%)
What are the 3 ventilator managements of status asthmaticus?
- Use low rate to increase exhalation time
- Use low tidal volumes to prevent auto-PEEP
- Increase inspiration/expiration (I/E) ratio (often greater than 1:3-4) to allow time for optimal exhalation and prevent auto-PEEP
(short inspiratory, long expiratory)
norm for pulmonary artery mean pressure
~20 mmHg
PAP and PAOP in pulmonary hypertension
PAP: >25 at rest
PAOP <16 mmHg at rest with secondary right heart failure
PF ratio in acute lung injury vs ARDS
ALI: P/F 201-300
ARDS: P/F <200
Define AC vent mode
Every breath (machine or self triggered) has same tidal volume
Define SIMV vent mode
Pt gets tidal volume at set breath rate, every extra breath above the set rate are spontaneous at the pt’s own tidal volume
Normal tidal volume? how about in ARDS?
norm: 8-10 mL/kg
ARDS: 4-6 mL/kg (in order to prevent volutrauma)
what is a normal plateau pressure?
what si a normal peak inspiratory pressure?
plateau pressure (i think less than 30) dunno yet
dynamic vs static compliance
dynamic is airway compliance
static is lung compliance
If the PAOP is high…… then what condition do you have?
pulmonary edema, most likely cardiac origin
electrolyte imbalances can cause what ABG
metabolic alkalosis
which vent setting helps “blow off” CO2?
PPV positive pressure ventilation
