Special Procedures and Non-Conventional Ventilatory Techniques

Question 1

Which cells secrete surfactant

Answer 1

Type II

Question 2

True or False: Phospholipids are an integral part of surfactant

Answer 2

True

Question 3

Which of the surface proteins (A,B,C or D) in surfactant support the physiologic activity of surfactant?

Answer 3

B and C

Question 4

Death is usually the result (unless a lung transplant can take place) if which of the surface proteins is low or deficient?

Answer 4

B

Question 5

Which type of surfactant lacks proteins? Synthetic or natural?

Answer 5

synthetic

Question 6

What is the dose of Infasurf

Answer 6

3 mL/kg

Question 7

What is the dose for Survanta

Answer 7

4 mL/kg

Question 8

What is the dose for Curosurf

Answer 8

2.5 mL/kg

Question 9

What is the dose for Surfaxin?

Answer 9

5.8 mL/kg

Question 10

If we decide to deliver surfactant to a neonate who has developed RDS, is this prophylactic or rescue treatment?

Answer 10

Rescue

Question 11

Delivering surfactant to an infant at high risk of developing RDS would be considered: (prophylactic or rescue)

Answer 11

prophylactic

Question 12

How is surfactant delivered?

Answer 12

directly - through the ET tube

Question 13

True or False: surfactant therapy has been shown to reduce the risk of developing BPD

Answer 13

True

Question 14

What ventilator parameters should you expect to decrease after surfactant administration?

Answer 14

Vt, Pressures, FiO2

Question 15

Is bradycardia in an infant a sign of improvement or decline?

Answer 15

decline

Question 16

What are the hazards of High-Frequency Ventilation?

Answer 16

gas trapping, hyperinflation, secretions obstructing airway, hypotension, and necrotizing tracheobronchitis

Question 17

When assessing adequate ventilation, what does the clinical look for in the chest assessment of a neonate on high-frequency ventilation?

Answer 17

chest wall vibration (wiggle)

Question 18

Ventilating the patient as low pressures is a benefit of high-frequency ventilation. This reduces the risk of

Answer 18

barotrauma

Question 19

True or False: HFOV produces both a positive and a negative stroke

Answer 19

True

Question 20

High-Frequency Ventilation (HFV) delivers respiratory rates that are great than

Answer 20

150 per minute

Question 21

iNO must be delivered in conjunction with

Answer 21

Oxygen

Question 22

Which type of HFV delivers the highest rates?

Answer 22

HFOV, High Frequency Oscillatory Ventilation

Question 23

What are the hazards of iNO

Answer 23

increased levels of nitrogen dioxide, and methemoglobinemia

Question 24

Titrating and withdrawal of iNO should be done (quickly or slowly)

Answer 24

slowly

Question 25

ECLS (extracorporeal life support) is initiated in infants at ______% chance mortality or greater.

Answer 25

80

Question 26

What is the mixture of helium and oxygen called?

Answer 26

heliox

Question 27

Which ECLS route supports cardiac output?

Answer 27

venoarterial

Question 28

What is the purpose fo the patient bridge in the ECLS circuit?

Answer 28

to maintain patency of circuit when patient is not connected

Question 29

What are the hazards/complications of ECLS

Answer 29

bleeding, hypotension or hypertension, anemia, leukopenia, thrombocytopenia, infeciton risk

Question 30

Is partial liquid ventilation compatible with surfactant?

Answer 30

yes

Question 31

What are the benefits of negative pressure ventilation?

Answer 31

little risk of barotrauma, little risk of complications associated with invasive positive pressure ventilation, and the cardiac system is not compromised like it is with positive pressure ventilation.

Question 32

True or False: There is a decreased risk of pneumothorax with HFV than with traditional ventilator modes and parameters

Answer 32

True

Question 33

Which type of HFV, according to our text, is used in tandem with a conventional ventilator?

Answer 33

High Frequency Jet Ventilation (HFJV)

Question 34

What is the name of the chemical used for partial liquid ventilation therapy?

Answer 34

perfluorochemicals (PFCs)