Respiratory

Question 1

Hypoxemic Respiratory Failure

Answer 1

Failure of oxygen exchange
Defined as PaO2 < 60 mm Hg at sea level

Question 2

Hypercarbic Respiratory Failure

Answer 2

Failure to exchange or remove carbon dioxide
Defined as PaCO2 > 45 mm Hg

Question 3

cent/perfusion V/Q Mismatch conditions

Answer 3

COPD/Asthma
Pulmonary Edema
Pulmonary Embolism
Pneumonia
ARDS

Question 4

high flow NC disadvantages

Answer 4

Unreliable Inspired Fraction of Oxygen (FiO2)

Does not provide positive pressure

Does not reduce work of breathing

Does not augment tidal volume or minute ventilation
Therefore does not assist with management of acute hypercarbia

Does not provide warming or humidification of inhaled gas

Question 5

HF settings

Answer 5

FiO2
21 – 100%
Gas Flow Rate
Up to 60L/min

Question 6

HF advantages

Answer 6

Small pliable nasal prongs
Facilitates talking, eating, etc
.
Near universal tolerance
Warms and Humidifies Inhaled Gas

High flow offers resistance against expiratory flow thereby increasing airway pressure
Function of flow rate – the higher the flow rate, the higher the PEEP

Question 7

Noninvasive Positive Pressure Ventilation (NIPPV)

Answer 7

CPAP
BPAP

Question 8

Indications for BPAP

Answer 8

Acute (on Chronic) Hypoxic Respiratory Failure
Acute (on Chronic) Hypercarbic Respiratory Failure*
Increased Work of Breathing
Obstructive Sleep Apnea/Obesity Hypoventilation Syndrome
Respiratory Muscle Weakness*

Question 9

Contraindications to NIPPV

Answer 9

Severe Encephalopathy
Inability to cooperate and/or protect airway
Inability to clear secretions
Upper Airway Obstruction
Upper GI Bleed
Intractable vomiting
High risk for aspiration
Significant hemodynamic instability
Maxillofacial Surgery
Base of Skull Fracture
Cardiac/Respiratory Arrest

Question 10

invasive ventilation indications

Answer 10

Acute (on Chronic) Hypoxic Respiratory Failure*
Acute (on Chronic) Hypercarbic Respiratory Failure*
Increased Work of Breathing*
Inability to Protect Airway
Secretions, blood, vomit
Decreased mental status
Permit Procedures which require deep sedation/general anesthesia
Cardiac and/or Respiratory Arrest

Question 11

ARDS criteria

Answer 11

Diagnostic criteria include onset within one week of a known insult or new or worsening respiratory symptoms, profound hypoxemia, bilateral pulmonary opacities on radiography, and inability to explain respiratory failure by cardiac failure or fluid overload

Question 12

Minimizing Barotrauma & Volutrauma Low Tidal Volume should be

Answer 12

: 6 mL/kg ideal body weight